Repairing Bilateral Coronary-Pulmonary Artery Fistulas During Coronary Artery Bypass Grafting

Alexander L. Chen, DO; Alessandro Vivacqua, MD; Jeffrey M. Altshuler, MD; Francis L. Shannon, MD; Rajesh C. Gulati, MD; Thomas A. Schwann, MD; Bogdan A. Kindzelski, MD, MS

Annals of Thoracic Surgery Short Reports (Sep 2024)

Repairing Bilateral Coronary-Pulmonary Artery Fistulas During Coronary Artery Bypass Grafting

Alexander L. Chen, DO,
Alessandro Vivacqua, MD,
Jeffrey M. Altshuler, MD,
Francis L. Shannon, MD,
Rajesh C. Gulati, MD,
Thomas A. Schwann, MD,
Bogdan A. Kindzelski, MD, MS

Affiliations

Alexander L. Chen, DO: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Alessandro Vivacqua, MD: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Jeffrey M. Altshuler, MD: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Francis L. Shannon, MD: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Rajesh C. Gulati, MD: Department of Cardiovascular Medicine, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Thomas A. Schwann, MD: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan
Bogdan A. Kindzelski, MD, MS: Department of Cardiovascular Surgery, Corewell East William Beaumont University Hospital, Royal Oak, Michigan; Address correspondence to Dr Kindzelski, Corewell Health East William Beaumont University Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073.

Journal volume & issue: Vol. 2, no. 3
pp. 394 – 396

Abstract

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Coronary-pulmonary artery fistulas (CPAFs) are rare entities that can cause significant left-to-right shunting and complicate routine coronary artery bypass grafting. There are no best practice guidelines and a scarcity of reports regarding concomitant treatment of CPAF with coronary artery disease. We present a case of bilateral CPAFs in a 60-year-old man with symptomatic coronary artery disease treated successfully with coronary artery bypass, epicardial ligation, and transpulmonary closure of CPAF with patch reconstruction. This case highlights the importance of optimal myocardial protection and complete closure of the fistula to prevent risk of coronary steal.

Published in Annals of Thoracic Surgery Short Reports

ISSN: 2772-9931 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Surgery; Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system
Website: https://www.sciencedirect.com/journal/annals-of-thoracic-surgery-short-reports

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