[Congenital coronary fistulas: report of six operated cases (author's transl)].

The authors report of their own experience of 6 patients suffering from congenital coronary fistula. In 3 cases the fistula originated from the right coronary artery and in the other 3, from the branches of the left coronary artery. In 2 cases the fistula ended in the right atrium and in 4 cases in the right ventricle. Three patients were asymptomatic, 2 with cardiac insufficiency and 1 suffering from angor. We normally recommend surgical operation for the symptomatic patients, and for the asymptomatic, whenever there is a considerable shunt sin/dx and/or for important electrocardiogram alteration. All of the patients was operated on, 4 of them by means of extracorporeal circulation. In 3 of them a straight ligation of the fistula was carried out: in one, ligation of the fistula associated with the removal of a myocardial aneurysm, in one the suture of the intima of the fistula after arteriotomy, and in one the suture after right atriotomy. There were no complications immediately after the surgical operation. Five of our patients were checked from 3 to 7 years after the operation. All of them showed a normal radiological picture and disappearance of electrocardiogram evidence of pre-existing myocardial ischemia.