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Eur J Cardiothorac Surg 2006;30:559
© 2006 Elsevier Science NL

Images in cardio-thoracic surgery

Left circumflex coronary artery to coronary sinus fistula

Giuseppe De Ciccoa,*, Carlo Fuccia, Andrea Borghesib, Roberto Lorussoa

a Cardiac Surgery Unit, Civic Hospital, Brescia, Italy
b Department of Radiology, University of Brescia, Brescia, Italy

Received 5 May 2006; accepted 26 June 2006.

* Corresponding author. Address: U.O. di Cardiochirurgia, Spedali Civili di Brescia, Piazzale Spedali Civili, 1-25125 Brescia, Italy. Tel.: +39 030 3995637; fax: +39 030 3995004. (Email: giudeci{at}libero.it).

Key Words: Coronary disease • Circumflex coronary artery • Coronary fistula

We report a case of a 63-year-old woman who was admitted at our institution for unstable angina with a severe coronary disease and circumflex coronary artery fistula draining to the coronary sinus (Fig. 1 ). Surgical treatment was revascularization of the diagonal branch (no reperfusion of the LAD) and ligation of the fistula.


Figure 1
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  		Fig. 1. (A) Multislice cardiac spiral tomography showing circumflex coronary artery fistula. (B) Coronary angiography showing coronary artery disease and the circumflex artery to coronary sinus fistula. (C) Intraoperative image showing the origin of the circumflex coronary artery fistula and its anatomical relationships. RCA, right coronary artery; LAD, left anterior descending artery; F, fistula; Diag, diagonal branch; PA, pulmonary artery.

 





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