Cardiopulmonary Arterioarterial Fistulae After Myocardial Revascularization: A Coronary Steal Syndrome

In a woman with typical angina pectoris and angiographic evidence of marked reduction of coronary flow, both internal mammary arteries were implanted into the myocardium. Angiography 19 and 24 months later showed fistulous communications between the right internal mammary, the left coronary, and the left pulmonary arteries, indicating the possibility of a coronary steal syndrome. Dense adhesions traversed by numerous small arteriolized vessels between the lingula of the left lung and the anteriolateral surface of the left ventricle were subsequently divided. Her anginal pain subsided. No similar case has been found in the literature.