Online ISSN: 2187-2988 Print ISSN: 0911-1794
特定非営利活動法人日本小児循環器学会 Japanese Society of Pediatric Cardiology and Cardiac Surgery
Pediatric Cardiology and Cardiac Surgery 32(3): 232-236 (2016)

症例報告Case Report

心筋壁内走行を合併した左右冠動脈–右室瘻に対し右室内腔より瘻孔閉鎖を施行した1例Surgical Correction of Bilateral Coronary Arterial-right Ventricular Fistula

1和歌山県立医科大学第一外科The First Department of Surgery, Wakayama Medical University ◇ Wakayama, Japan

2和歌山県立医科大学小児科Department of Pediatrics, Wakayama Medical University ◇ Wakayama, Japan

受付日:2016年1月18日Received: January 18, 2016
受理日:2016年3月28日Accepted: March 28, 2016
発行日:2016年5月1日Published: May 1, 2016


Coronary artery fistula (CAF) is a rare congenital anomaly, and a bilateral coronary artery origin is especially rare. We report the case of a 4-year-old boy who was diagnosed with a heart murmur without symptoms at 7 months of age. He underwent CAF closure via right ventriculotomy. Most cases of CAF are clinically asymptomatic in young patients. The CAF treatment strategy is determined by the symptoms, properties of the aneurysmal vessel, and the size of the fistula. As heart failure and exertional angina gradually appear in adulthood, treatment may be required earlier after diagnosis, depending on the patient’s condition. Various surgical options for closing the fistula have been reported; however, we selected right ventriculotomy in this case because of myocardial bridging of the fistula coronary arteries.

Key words: coronary artery fistula; myocardial bridging; coronary arterial aneurysmal change; right ventriculotomy

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