Plexus Network between Internal Mammary Graft and Pulmonary Vasculature after Coronary Bypass Grafting

Received 17 July 2007; received in revised form 12 October 2007; accepted 31 October 2007.

Left internal mammary artery to pulmonary vasculature fistulas are rare complications following coronary artery bypass grafting surgery. In symptomatic cases, management may either be conservative, or involve coil embolisation or surgical ligation of the fistula. We describe a 52-year-old male patient who suffered from an acute coronary syndrome due to significant stenosis of the right coronary artery 12 years after coronary artery bypass grafting surgery. Coronary angiography accidentally revealed a fistulous connection between the left internal mammary artery and the left pulmonary vasculature. The patient underwent percutaneous coronary intervention for his right coronary artery and was managed conservatively for his fistula.

Keywords: Coronary artery bypass grafting, Internal mammary artery, Pulmonary artery, Fistula

a Departments of Cardiology, Montreal Heart Institute, University of Montreal, Montreal, QC H1T 1C8, Canada

b Radiology, Montreal Heart Institute, University of Montreal, Montreal, QC H1T 1C8, Canada

Corresponding author at: Interventional Cardiology, University of Montreal, Montreal Heart Institute 5000 Belanger Street, Montreal, QC H1T 1C8, Canada. Tel.: +1 514 376 3330; fax: +1 514 376 6299.

PII: S1443-9506(07)01085-2

doi:10.1016/j.hlc.2007.10.016

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