Abstract

With great interest, we read the report of Takahashi et al1 titled “Intraoperative Imaging and Off-Pump Ligation of Coronary Artery Fistula.” The management of coronary artery fistula (CAF) is indeed somewhat controversial, especially in younger, asymptomatic patients. It generally is agreed that symptomatic lesions and larger fistulae with significant shunting should be treated. Surgical ligation2 generally is accepted as the treatment of choice in CAF.

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