Imawaki S, Arioka I, Nakai M, Tsuruno Y, Takama T, Maeta H, Inagawa T
First Department of Surgery, Kagawa Medical School, Japan.
Surg Today. 1995;25(5):461-4. doi: 10.1007/BF00311829.
We report herein the rare case of a 56-year-old man who gradually developed congestive cardiac failure 6 months after undergoing coronary artery bypass grafting and was found to have a fistula between the internal mammary artery and the pulmonary artery of the upper lobe diagnosed by selective left internal mammary arteriogram. A second sternotomy was performed and demonstrated dense adhesion between the fissure surrounding the internal mammary artery and the upper lobe, and the fistula was resected. We believe that the patient's increasing cardiac failure was almost certainly caused by coronary seal.
