Coronary arteriovenous fistulas may cause important hemodyamic and clinical disturbances and must be treated surgically in almost all cases (₁).

A 12 months old boy was referred to our clinic with continuous cardiac murmur and failure to thrive. He was slightly underdeveloped (50-75 percentile) and echocardiograhic evaluation showed aneurismal dilation of the left sinus of Valsalva and connection between the left coronary sinus and left atrial appendage. The fistula was 10 mm in diameter and 15 mm long (Figure 1).

Figure 1

He was operated successfully with double ligation and division. Atrial side was simply closed with running sutures. His postoperative course was uneventful.