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Coronary
Minimally Invasive Repair of Aneurysmal Coronary-Pulmonary Artery Fistulas
The surgical indication for aneurysmal coronary-pulmonary artery fistula (CPAF) has not yet been established. We present 2 cases of aneurysmal CPAFs successfully treated with bilateral minithoracotomy. Case 1 involved a 40-year-old woman who presented with asymptomatic CPAFs and aneurysms measuring 25 mm in diameter. Considering her cosmetic concerns, CPAFs were surgically treated through minithoracotomy, with no major postoperative complications. In case 2, an 82-year-old woman with dyspnea was diagnosed with high-flow coronary-pulmonary artery shunts with aneurysms.Quantitative Myocardial Perfusion in Surgically Repaired Coronary Artery Anomaly
The anomalous aortic origin of the right coronary artery with an intramural course is rare and can cause myocardial ischemia, for which surgical repair is indicated. We present the case of a 49-year-old man with this anomaly whose preoperative myocardial perfusion positron emission tomography revealed inducible ischemia. Comparison of the preoperative and follow-up (6 months) positron emission tomography findings showed significant improvement in regional myocardial flow reserve and relative flow reserve, in keeping with the improvement in symptoms.
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