A Case of Thoracic Aortopulmonary and Left Coronary Artery-Pulmonary Artery Fistulas with Aneurysms Treated with Coil Embolization, Aneurysm Resection, and Fistula Closure

Yuria FURUYAMA; Kota KAWADA; Toru KAMEDA; Makoto KOYAMA; Tsubasa YOSHIKAWA; Erika HANJI; Takahide YAO; Shinnosuke OKUMA; Muneyasu KAWASAKI; Takeshiro FUJII

Return

A Case of Thoracic Aortopulmonary and Left Coronary Artery-Pulmonary Artery Fistulas with Aneurysms Treated with Coil Embolization, Aneurysm Resection, and Fistula Closure

VernacularTitle:瘤を伴った胸部大動脈肺動脈瘻および左冠動脈肺動脈瘻に対しコイル塞栓術と瘤切除術・瘻閉鎖術を併施した1例
Author: Yuria FURUYAMA ¹ ; Kota KAWADA ¹ ; Toru KAMEDA ¹ ; Makoto KOYAMA ¹ ; Tsubasa YOSHIKAWA ¹ ; Erika HANJI ² ; Takahide YAO ² ; Shinnosuke OKUMA ² ; Muneyasu KAWASAKI ³ ; Takeshiro FUJII ¹
Author Information

1. Department of Cardiovascular Surgery, Toho University Omori Medical Center
2. Department of Cardiovascular Surgery, Ikegami General Hospital
3. Department of Cardiovascular Surgery, Misato Central General Hospital
Keywords: Aortopulmonary fistula; coronary artery-pulmonary artery fistula; coronary aneurysm; hybrid therapy
From:Japanese Journal of Cardiovascular Surgery 2025;54(5):212-215
CountryJapan
Language:Japanese
Abstract: A 66-year-old man with an abnormal electrocardiogram during a health examination sought evaluation at the cardiology department. Contrast-enhanced computed tomography (CT) revealed the presence of aneurysms associated with aortopulmonary and left coronary artery-pulmonary artery fistulas. One of the identified aneurysms measured 20 mm. The patient was then referred to our department for surgical intervention. Although the patient was asymptomatic, surgery was planned due to the risk of rupture. Initially, coil embolization was performed to address the aortopulmonary fistula, which was followed by a median sternotomy. Intraoperatively, multiple tortuous abnormal vessels connecting both coronary arteries to the pulmonary artery were observed, along with aneurysms at the base of the pulmonary artery. The aneurysms were excised under cardiopulmonary bypass, and the opening of the pulmonary artery fistula was closed. Subsequent coronary angiography during surgery and postoperative cardiac CT confirmed the complete resolution of the abnormal vessels and aneurysms. The patient had an uneventful postoperative course and was discharged. We present the case of a patient with aneurysms associated with thoracic aortopulmonary and left coronary artery-pulmonary artery fistulas and review the relevant literature. The case was managed with a single-stage surgery involving coil embolization, aneurysm resection, and fistula closure.