Ruptured aneurysm of coronary arteriovenous fistula complicated with
A quarter of coronary arteriovenous fistulas may present aneurysmal
dilatation; however, spontaneous rupture of the aneurysm is rare. We
present a rare case of ruptured coronary artery aneurysm (CAA)
associated with coronary fistulas that presented cardiac tamponade.
Subsequent to pericardial drainage, surgical repair of the CAA
associated with coronary fistulas was performed electively. The aneurysm
was located on the left anterior aspect of the pulmonary artery trunk.
It communicated with both the left and right coronary arteries by
anomalous fistulous vessels that drained into the pulmonary artery
trunk. The feeding arteries and fistulous opening were ligated and
closed, respectively, from within the aneurysm. Intraoperative
fluorescence imaging was performed pre- and postoperatively to ensure no
residual coronary fistulas were present. Although the rupture of CAA
associated with coronary fistulas is rare, it should be considered as
one of the potential causes of acute cardiac tamponade.