Abstract
We reported a successfully operated case of ruptured coronary artery aneurysm which resulted from a coronary artery fistula. A 70-year-old woman who had been treated for hypertension developed syncope and profound shock. Echocardiography and chest CT-scan suggested the presence of cardiac tamponade. An emergency operation was done. An aneurysm was seen at the left side of the right heart outflow and pulmonary artery, on the proximal left anterior descending coronary artery. Closure of the orifice of the inflow and the outflow vessels of the aneurysm, and aneurysmorraphy was performed under cardiopulmonary bypass. Serpentine small arteries were found around the aneurysm and were simply ligated by mattress sutures. The postoperative course was uneventful, and coronary angiographic study demonstrated normal coronary distribution.
