Left circumflex artery aneurysm with fistula to the coronary sinus

  • Reiko KemmochiEmail author
  • Yuki Ohga
  • Youji Kubo
  • Mitsuaki Matsumoto
Case Report


A giant coronary artery aneurysm with arteriovenous fistula is a unique pathology having few surgical reports. An 82-year-old woman presented with a symptomatic giant left circumflex artery aneurysm with a fistula to the coronary sinus. The left coronary artery was dilated, and an aneurysmal change was visible from the left main trunk to the fistula. Surgery was performed to close the fistula and seclude all parts of the aneurysmal coronary artery. All coronary branches emerging from the aneurysm required bypass grafting. Herein, we present the history of this unusual case and our successful surgical strategy.


Coronary artery aneurysm Coronary artery fistula Surgical strategy 


Compliance with ethical standards

Conflict of interest

The authors have declared that no conflict of interest exists.


  1. 1.
    Hirose H, Amano A, Yoshida S, Nagao T, Sunami H, Takahashi A, et al. Coronary artery aneurysm associated with fistula in adults: collective review and a case report. Ann Thorac Cardiovasc Surg. 1999;5:258–64.PubMedGoogle Scholar
  2. 2.
    Mangukia CV. Coronary artery fistula. Ann Thorac Surg. 2012;93:2084–92.CrossRefGoogle Scholar
  3. 3.
    Libertini R, Wallbridge D, Jones HR, Gunning M, Satur CMR. Giant circumflex artery aneurysm with a coronary sinus fistula. Ann Thorac Surg. 2018;106:e223–e22525.CrossRefGoogle Scholar
  4. 4.
    Qureshi SA. Coronary arterial fistulas. Orphanet J Rare Dis. 2006;1:51.CrossRefGoogle Scholar
  5. 5.
    Nakahira A, Sasaki Y, Hirai H, Fukui T, Motoki M, Takahashi Y, et al. Rupture of aneurysmal circumflex coronary artery into the left atrium after ligation of its arteriovenous fistula. Circ J. 2007;71:1996–8.CrossRefGoogle Scholar
  6. 6.
    Hajj-Chahine J, Haddad F, El-Rassi I, Jebara V. Surgical management of a circumflex aneurysm with fistula to the coronary sinus. Eur J Cardiothorac Surg. 2009;35:1086–8.CrossRefGoogle Scholar

Copyright information

© The Japanese Association for Thoracic Surgery 2019

Authors and Affiliations

  1. 1.Department of Cardiovascular Surgery, Cardiovascular CenterTsuyama Chuo HospitalTsuyamaJapan

Personalised recommendations