Congenital Coronary Arteriovenous Fistula Associated with Large Patent Ductus

An unusual case of congenital coronary arteriovenous fistula is reported, bringing the total number of reported cases to 39. This is the second case in which the left coronary artery system communicated directly with the right atrium, and also the second case associated with a patent ductus. Our case is well documented by cardiac catheterization data, retrograde aortography, and postmortem findings. Although surgical correction of both the patent ductus and coronary arteriovenous fistula was accomplished without great difficulty, the patient died 30 hours postoperatively, presumably from the effects of severe pulmonary hypertension.