The Journal of Thoracic and Cardiovascular Surgery, Vol 82, 785-789, Copyright © 1981 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Right coronary-left ventricular fistula mimicking aortic valve insufficiency in infancy
AR Dobell and RW Long
Two infants had large communications between the right coronary artery just
distal to its origin and the cavity of the left ventricle. The findings
were essentially those of aortic insufficiency. In the first patient
operation was delayed until there was secondary aortic insufficiency
resulting from dilatation of the aortic root. The second patient was
operated upon in infancy, and abolition of the fistula has relieved the
clinical situation. Surgeons should recognize that isolated congenital
aortic valve insufficiency has not been reported to our knowledge.
Therefore, infants who appear to have this condition should undergo
thorough angiographic studies which likely will reveal a remediable
situation. A surgical approach for the type of fistula described herein is
presented.