Coronary–Pulmonary Arteriovenous Fistula: Used as Proximal Anastomotic Site for Saphenous Vein Grafts in Patient with Porcelain Aorta

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Coronary artery bypass grafting in patients with porcelain aorta and calcified great vessels is associated with a high risk of systemic embolism. Various techniques have been suggested to minimize that risk. We describe the case of a patient with left main coronary disease and a severely calcified ascending aorta, who could not undergo cardiopulmonary bypass. To the best of our knowledge, this is the 1st reported use of a congenital coronary–pulmonary arteriovenous fistula as a proximal anastomotic site for saphenous vein grafts, to achieve optimal revascularization in a patient with porcelain aorta.(Tex Heart Inst J 2003;30:143–5)

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