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Eur J Cardiothorac Surg 2001;20:850-852
© 2001 Elsevier Science NL

How to do it

Surgical repair of coronary arteriovenous fistula: a simple and useful approach to identify the fistulous communication

Department of Cardiovascular Surgery, Kumamoto Central Hospital, Kumamoto, Japan

Received 30 April 2001; received in revised form 3 July 2001; accepted 10 July 2001.

Corresponding author. Tel.: +81-96-370-3111; fax: +81-96-370-4005
e-mail: tkoshiji{at}hotmail.com

In repairing coronary arteriovenous fistula (CAVF), it is very important to interrupt the fistulous tract without compromise of normal coronary vessel flow. In our case, selective coronary arteriography showed that the CAVF from the left anterior descending coronary artery (LAD) was very close to the native coronary artery and had a very broad and short neck. We describe a simple and useful approach, by using both antegrade and retrograde coronary perfusion, that makes it possible to certainly protect myocardium and to clearly distinguish the normal native coronary artery from the fistulous tract.

Key Words: Coronary arteriovenous fistula • Selective coronary arteriography • Angina pectoris • Antegrade coronary perfusion • Retrograde coronary perfusion • Aneurysmal formation • Surgical repair

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