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Abstract
The clinical usefulness of intraoperative epicardial echocardiography in a patient with post-infarction angina complicated by a coronary-pulmonary artery fistula (CPAF) with aneurysmal change was reported. Epicardial echocardiography clearly showed feeding arteries to the fistula in the myocardium, which was not revealed by visual inspection, palpation, or transesophageal echocardiography. The patient was received off-pump coronary artery bypass grafting concomitant with aneurysmectomy. The feeding arteries were dissected easily using an ultrasonic scalpel and successfully ligated. The flow in the aneurysm disappeared immediately and aneurysmectomy was performed without bleeding. Intraoperative epicardial echocardiography was useful method during off-pump resection of CPAF.
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