[A successful surgical treatment of left coronary artery-pulmonary artery fistula with giant saccular aneurysm].

A surgical case of left coronary artery-pulmonary artery fistula with giant saccular aneurysm was reported. The aneurysm was successfully resected under total extra-corporeal circulation. The patient was 67-year-old female who was admitted for evaluation of chest pain and heart murmur. On coronary angiography, the diagnosis was made as a coronary artery fistula originating from the left anterior descending artery and draining into the pulmonary artery. The operation was indicated by the fact that the combination with giant saccular aneurysm and positive findings of ischemic changes on exercise electrocardiogram. Intraoperative flowmetry on the fistula revealed that estimated average flow was 200 ml/min and the coronary steal phenomenon was strongly suggested. We concluded that surgical treatment for coronary fistula with giant aneurysm can be done with minimal risk.