Surgical treatment of coronary artery aneurysm with coronary artery fistula.

Coronary artery aneurysm (CAA) is an uncommon disease with an incidence of 1%-5% in evaluated patients. Atherosclerosis is its most common etiology in adults, occurring in 50% of cases. Also, CAA is associated with predisposing factors such as Kawasaki disease, stent-angioplasty, and notably, coronary artery fistula. Most CAAs are asymptomatic but occasionally lead to life-threatening conditions, such as rupture, infection, and myocardial ischemia. Thus caution is urged for cardiac surgeons. We here report on seven surgical cases of CAA with coronary artery fistula in our institute, focusing on their surgical treatment.