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J Thorac Cardiovasc Surg 2005;129:225-226
© 2005 The American Association for Thoracic Surgery


Brief Communications

Coronary artery bypass graft using the right coronary artery–pulmonary artery fistula

Luís A. Dallan, MD*, Luiz Augusto F. Lisboa, MD, Carlos Alberto C. Abreu Filho, MD, Fernando Platania, MD, Sérgio Almeida De Oliveira, MD

Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil

Received for publication May 3, 2004; accepted for publication May 10, 2004.

* Address for reprints: Luís Alberto O. Dallan, MD, Av. Inhambu, 917 Ap. 191, São Paulo, SP, 04520-013, Brazil (E-mail: dcidallan@incor.usp.br).

The first 20% of the full text of this article appears below.


Dr Dallan


We report the case of a 72-year-old man with a congenital coronary fistula between the right coronary artery (RCA) and the main pulmonary artery (PA) associated with coronary atherosclerosis. He remained asymptomatic until 72 years of age, when myocardial ischemia developed. Myocardial revascularization was performed using four saphenous vein grafts. In addition, the coronary fistula was dissected, distally sectioned, and also used as a graft to a suboccluded coronary artery branch.


    Clinical summary
 
A 72-year-old man with a history myocardial ischemia was admitted at our hospital for management of unstable angina. He was asymptomatic but recently had had progressive chest pain. Coronary angiography revealed severe atherosclerotic coronary artery disease associated with an RCA-PA fistula (Figure 1). Coronary artery catheterization showed proximal stenosis in both the left anterior descending coronary artery and the circumflex coronary artery; it also revealed stenosis in the middle segment of the RCA distal to the fistula, . . . [Full Text of this Article]







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