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November 1966

Congenital Coronary Artery FistulaIndications for Operative Treatment

Author Affiliations

From the Department of Surgery, University of Kansas School of Medicine and Medical Center, Kansas City.

Arch Surg. 1966;93(5):772-775. doi:10.1001/archsurg.1966.01330050076011

CORONARY artery fistulas as used in this presentation refer to communications between the coronary arteries and a low pressure cardiac chamber or pulmonary artery. Such lesions are not uncommon and diagnostic methods permit precise diagnosis. However, further consideration is needed regarding their proper management. The purposes of this paper are to describe briefly five patients with coronary artery fistulas and our treatment of them.

The cases are summarized in the Table. In view of the types of pathologic conditions found, additional comment is given for each.

Report of Cases 

Case 1.  —This 3½-year-old patient presented with an atypical ductus murmur, a continuous murmur along the left and right lower sternal border. There was evidence of left ventricular hypertrophy on the electrocardiogram and vectorcardiogram. Cardiac catheterization was done which revealed normal pressures with a small (less than one vol%) left to right shunt at the atrial level. The coronary fistula was

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