• Eur J Cardiothorac Surg · Sep 1999

    Case Reports

    Intraoperative localisation and management of coronary artery fistula using transesophageal echocardiography.

    • I Kadir, R Ascione, S Linter, and A J Bryan.
    • Bristol cardiothoracic Centre, Bristol Royal Infirmary, UK.
    • Eur J Cardiothorac Surg. 1999 Sep 1;16(3):364-6.

    AbstractCoronary artery fistula is a rare congenital malformation that can be complicated by intracardiac shunts, endocarditis, myocardial infarction, coronary aneurysm and sudden death. Clinical symptomatology depends upon the underlying anatomy and the size of the fistulous connection between the left or right side of the heart. We report the successful management of a giant right coronary artery with fistulization into the right atrium. Intraoperative transesophageal echocardiography with colour flow Doppler was used for precise location of the fistulous communication, selective demonstration of vessels feeding the fistula and documentation of abolition of fistulous flow all without the need for cardiopulmonary bypass. Furthermore the effect of shunt occlusion on regional wall motion was documented which facilitated the successful ligation of the fistula.

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