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Eur J Cardiothorac Surg 2006;30:397-399
© 2006 Elsevier Science NL

Case report

Undiagnosed coronary fistula causing low cardiac output syndrome after pediatric heart surgery

Pediatric Heart Center, UCSF Children's Hospital, Division of Pediatric Cardiothoracic Surgery, 513 Parnassus Avenue, Suite S-549, Box 0117, San Francisco, CA 94143-0117, USA

Received 8 February 2006; received in revised form 10 May 2006; accepted 15 May 2006.

^_* Corresponding author. Tel.: +1 415 476 3501; fax: +1 415 476 9678. (Email: karlt{at}surgery.ucsf.edu).

A patient with preoperative pulmonary hypertension and a large left to right intracardiac shunt underwent surgical correction of a complex cardiac anomaly and required extracorporeal life support for unexplained ventricular dysfunction following the procedure. Following recovery, a fistulous connection between the right coronary artery and main pulmonary artery was demonstrated. Implications and management strategies of unsuspected coronary fistula in pediatric heart surgery are discussed.

Key Words: Vascular fistula • Coronary vessel anomalies • Extracorporeal circulation