Diagnosis and surgical treatment of coronary artery fistula.

Phonocardiography is of great importance in distinguishing coronary artery fistula from other anomalies with a continuous murmur. The presence of this murmur at the apex must be regarded as an important characteristic of a coronary artery fistula, especially when the maximum diastolic murmur is found at the apex. Although coronary artery fistula may be symptomless for a long time, surgical treatment is desirable in most cases. Extracorporeal circulation should be used in all operations for coronary artery fistula to avoid ligation of the wrong artery or failure to close all fistula orifices.