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Vascular and Endovascular Surgery
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Aneurysmal Right Coronary Artery to Left Ventricle Fistula Associated with Atrial Septal Defect and Aortic Insufficiency: Surgical Considerations

A Case Report

Dimitris J. Nikas

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

Vaskar Mukerji

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

Milton D. Concannon

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

Clara V. Massey

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

Thea C. Moran

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

Martin A. Alpert

Divisions of Cardiothoracic Surgery and Cardiology, University of South Alabama College of Medicine, Mobile, Alabama

A sixty-seven-year-old woman with effort intolerance and presyncope was noted to have a congenital aneurysmal right coronary artery to left ventricular fistula, an ostium secundum atrial septal defect, and severe aortic insufficiency. This is the first case reported with this combination of cardiac anomalies. The diagnosis was confirmed by cardiac catheterization, coronary angiography, and aortography. Aortic valve replace ment, closure of the atrial septal defect, and ligation of the right coronary artery to left ventricle fistula were performed without incident. The patient has remained asympto matic since surgery.

Vascular and Endovascular Surgery, Vol. 28, No. 6, 425-428 (1994)
DOI: 10.1177/153857449402800607
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