Yamaki F, Nakajima M, Hirayama T, Kume S
Department of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1993 Nov;41(11):2229-33.
A 63-year-old women experienced acute heart failure due to a ruptured aneurysm resulting from the coronary artery fistula which originated from the left anterior descending artery. On surgery, the pericardial cavity was found filled with massive hemorrhagic fluid and perforation was detected on the surface of the aneurysm, sphere-shaped with a approximate diameter of 50 mm. Operation was done by closure of fistula and subsequent aneurysmectomy under extracorporeal circulation. Post operative course had been uneventful. Coronary artery fistula accompanied with aneurysm had been thought to have a high risk of rupture and to be in indication of surgical intervention. This case report was undertaken with bibliographical consideration, since there had been only a few reports of actual ruptures.