Surgical Correction of Bilateral Coronary Arterial-right Ventricular Fistula

Abstract

Coronary artery fistula (CAF) is a rare congenital anomaly, and a bilateral coronary artery origin is especially rare. We report the case of a 4-year-old boy who was diagnosed with a heart murmur without symptoms at 7 months of age. He underwent CAF closure via right ventriculotomy. Most cases of CAF are clinically asymptomatic in young patients. The CAF treatment strategy is determined by the symptoms, properties of the aneurysmal vessel, and the size of the fistula. As heart failure and exertional angina gradually appear in adulthood, treatment may be required earlier after diagnosis, depending on the patient’s condition. Various surgical options for closing the fistula have been reported; however, we selected right ventriculotomy in this case because of myocardial bridging of the fistula coronary arteries.