Coronary-Pulmonary Artery Fistula Ligation and Mitral Valve Repair Through a Mini-Thoracotomy Approach.

Abstract

A 39-year-old man with severe mitral regurgitation was referred to our institution for surgical evaluation. During preoperative workup, a coronary-pulmonary artery fistula was incidentally found by computed tomography. After multidisciplinary cardiac team discussion, the decision was made to proceed with coronary-pulmonary artery fistula ligation and mitral valve repair through a mini-thoracotomy approach. Cardiopulmonary bypass was initiated with femoral vessels. A mini-thoracotomy was made in the fourth intercostal space. First, mitral valve repair with posterior leaflet folding and ring annuloplasty was done. The coronary-pulmonary artery fistula was running on the roof of the left atrium and was ligated with metal clips under thoracoscopic vision. Postoperative computed tomography showed no residual fistula.

• Authors: Hiroto Kitahara, Chiharu Tanaka, Sentaro Nakanishi, Naohiro Wakabayashi, Natsuya Ishikawa, Hiroyuki Kamiya
• Journal: Innovations (Philadelphia, Pa.) (Innovations (Phila)) Vol. 14 Issue 3 Pg. 272-275 (Jun 2019) ISSN: 1559-0879 [Electronic] United States
• PMID: 30885087 (Publication Type: Case Reports, Journal Article)

Topics

• Adult
• Arterio-Arterial Fistula (complications, diagnostic imaging, surgery)
• Coronary Angiography
• Coronary Artery Disease (complications, diagnostic imaging, surgery)
• Echocardiography
• Humans
• Imaging, Three-Dimensional
• Ligation
• Male
• Mitral Valve Annuloplasty (methods)
• Mitral Valve Insufficiency (complications, diagnostic imaging, surgery)
• Pulmonary Artery (diagnostic imaging, surgery)
• Thoracotomy (methods)
• Tomography, X-Ray Computed