Hybrid Approach to Closure of an Acquired Coronary-Cameral Fistula

Coronary-cameral fistula is an abnormal fistulous communication between a coronary artery and a cardiac chamber. Significant fistulae require closure either percutaneously or surgically to avoid any complications. We describe the case of a 19-year-old male patient with tetralogy of Fallot, who presented with a complex coronary-cameral fistula, which precluded percutaneous occlusion. By means of a hybrid approach, the fistula was easily located and closed surgically. Where surgical correction of such fistulae is warranted in the setting of other cardiac defects, a hybrid approach to isolate the fistula followed by surgical intervention will reduce operative time, thereby potentially lowering perioperative complications. (C) 2014 by The Society of Thoracic Surgeons