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. Given her age and frailty, surgical closure through minithoracotomy was indicated for the symptoms of heart failure caused by significant left-to-right shunts.