Congenital Coronary Artery Fistula Associated with Infective Endocarditis of the Mitral Valve

Abstract

A 54-year-old woman complained of prolonged fever. Echocardiography showed severe mitral regurgitation with vegetation, and computed tomography showed right coronary artery (RCA) fistula to the coronary sinus (CS). Blood culture revealed Strep. viridans, thus a diagnosis of active infective endocarditis was established. The patient underwent urgent surgery. Surgical findings showed that vegetation was located in A3 to P3 of the mitral valve. The patient underwent mitral valve repair using a glutalualdehyde-treated autologous pericardial patch and artificial chordea. Epicardial ligation for fistula was performed. Her postoperative course was uneventful.