Surgical repair of coronary arteriovenous fistula: a simple and useful approach to identify the fistulous communication.

In repairing coronary arteriovenous fistula (CAVF), it is very important to interrupt the fistulous tract without compromise of normal coronary vessel flow. In our case, selective coronary arteriography showed that the CAVF from the left anterior descending coronary artery (LAD) was very close to the native coronary artery and had a very broad and short neck. We describe a simple and useful approach, by using both antegrade and retrograde coronary perfusion, that makes it possible to certainly protect myocardium and to clearly distinguish the normal native coronary artery from the fistulous tract.