Ruptured Saccular Aneurysm Associated with a Coronary Artery to Pulmonary Artery Fistula / 日本心臓血管外科学会雑誌

ABSTRACT

We report successful operative treatment of a ruptured coronary artery saccular aneurysm associated with a coronary-pulmonary artery fistula. A 66-year-old woman experienced sudden onset of unconsciousness due to cardiac tamponade. Echocardiogram and chest CT on admission showed pericardial effusion and a 50-mm diameter saccular coronary artery aneurysm. Coronary angiogram revealed coronary artery aneurysm which arose on the conus branch of the right coronary artery. The connection between the aneurysm and the pulmonary artery was not clarified. Cardiac tamponade due to rupture of the saccular coronary artery aneurysm was suspected and emergency operation was performed. Operative findings revealed coronary-pulmonary artery fistula. Closure of the orifice of the draining artery to the pulmonary artery, and aneurysmorrhaphy were performed. Postoperative coronary angiogram and chest CT showed no residual fistula, and the postoperative course was uneventful.