Abstract
Coronary artery fistulas (CAF) are uncommon cases. They may cause myocardial ischemia, arrhythmia, pulmonary hypertension, and heart failure. Treatment options are controversial and not clear. In this article we report surgical management of a case with right coronary artery fistula and concurrent coronary artery disease. A sixty-years-old male patient with stable angina symptoms admitted to our medical center. Coronary angiography examination showed a right coronary artery to pulmonary artery fistula and significant right coronary artery lesion located after the fistula's origin. CAF ligated epicardially and right coronary revascularization was performed. Coronary arterial fistulas cause important hemodynamic problems. Surgical and transcatheter interventional treatments are treatment options. Therefore indications for treatment are very important for these patients. The best therapeutic strategy (surgery or transcatheter intervention) is debatable. The surgical treatment is controversial especially for asymptomatic and small fistulas. However, there is consensus that large and symptomatic fistulas should be treated. Further research is necessary to deepen these observations.
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