Coronary cameral fistulas (CCFs) are rare arteriovenous malformations that may be congenital or acquired. The presentation of CCFs varies from asymptomatic in early age to symptomatic and start of complications upon aging. Although percutaneous closure with embolization can also be done, surgical closure of CCFs is a gold standard of treatment. We present the case of a 20-year-old patient with a fistula connecting right coronary artery and the right atrium, along with aortic valve endocarditis and congestive cardiac failure.
Cardiac surgery involves use of cardiopulmonary bypass which usually requires a circulatory circuit containing numerous cannulae and tubings draining from major vessels (like superior and inferior vena cavae) and returning it back to the systemic circulation (via the aorta, femoral artery, axillary artery etc). Establishment of this circuit not only requires good surgical skills for technical procedures but also requires stringent vigilance and awareness about the working of these disposable items. Surgeons concentrating in the technical aspect might miss out on the minor manufacturing defects in these disposable items and anesthesiologist as well as perfusionist can contribute in this aspect by including systematic precheck of these items to avoid complications in future. In this case report, we would like to discuss a simple case of mitral valve replacement where during aortic decannulation the metallic tip got dislodged and thus got migrated to the abdominal aorta. This is a rare complication which none of us were expecting. By prechecking the various components of the cardiopulmonary bypass circuit, this complication was expected to be avoided.
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