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Minimally Invasive Ligation of Coronary Artery Fistula

Department of Cardiothoracic Surgery Escorts Heart Institute and Research Centre New Delhi, India

For reprint information contact: Krishna S Iyer, MCh Pediatric & Congenital Heart Surgery Escorts Heart Institute and Research Centre Okhla Road New Delhi 110025, India Tel: 91 11 684 4820 Fax: 91 11 683 2605 Email: skkaushal{at}hotmail.com

Successful surgical occlusion of a left anterior descending coronary artery-to-right ventricular fistula through a minimally invasive route is described. The fistula was ligated epicardially through a small midline pericardial window created in the xiphisternum without myocardial dissection, cardiac arrest, or cardiopulmonary bypass. Intraoperative transesophageal echocardiography played a crucial role in locating the site of the fistula, thereby allowing a minimally invasive surgical approach and assessment of the adequacy of repair.