A 58-year-old woman with a history of giant coronary artery to coronary sinus fistula, status after an attempted surgical closure 11 years ago, presented with worsening dyspnea and dilated cardiomyopathy. Diagnostic workup with cardiac catheterization and computed tomographic angiography revealed a high output circulation with persistent right and left coronary fistulae (Figure 1, Videos 1 and 2). Reoperation was undertaken with right axillary and femoral venous peripheral cannulation for cardiopulmonary bypass because of the retrosternal, massively dilated coronary fistulae.
A 58-year-old woman with a history of giant coronary artery to coronary sinus fistula, status after an attempted surgical closure 11 years ago, presented with worsening dyspnea and dilated cardiomyopathy. Diagnostic workup with cardiac catheterization and computed tomographic angiography revealed a high output circulation with persistent right and left coronary fistulae (Figure 1, Videos 1 and 2). Reoperation was undertaken with right axillary and femoral venous peripheral cannulation for cardiopulmonary bypass because of the retrosternal, massively dilated coronary fistulae.