Giant Right Coronary Artery Aneurysm with Coronary Artery Fistula to Right Atrium

Ryota Nomura	Masanao Nakai	Mitsuomi Shimamoto
Fumio Yamazaki	Tatsuya Itonaga	Tatsuji Okada
Yasuhiko Terai	Yuta Miyano and Yoshisuke Murata

（Department of Cardiovascular Surgery, Shizuoka City Hospital, Shizuoka, Japan）

We describe successful surgical treatment of a right coronary artery aneurysm associated with a fistula to the right atrium（RA). The patient was a 50-year-old man who complained of palpitations. ECG showed supraventricular extrasystole, and coronary CT revealed a remarkably dilated and undulating fistulous tract originating from the region corresponding to the orifice of the normal right coronary artery（RCA). The fistulous tract detoured to the posterior wall of the RA. An RCA of normal size originating from the midway of the fistulous tract was observed. The patient was operated on under cardio-pulmonary bypass. An aortocoronary bypass was performed, using a radial artery graft to section of the RCA that had a normal diameter. The RCA was subsequently ligated at the proximal side of the anastomosis. The orifice of the fistulous tract from the aorta was closed with a patch, and the entrance to the RA was also closed with mattress sutures. The postoperative recovery was uneventful, and he was discharged on the 19th postoperative day. Currently, the patient has been doing well without any complaints at 2 years postoperatively.

 

Jpn. J. Cardiovasc. Surg. 43:234-237（2014）

Keywords：right coronary artery to right atrium fistula;congenital coronary artery fistula;CABG