Late-term myocardial infarction after surgical ligation of a giant coronary artery fistula.

A case is presented of a patient with recurrent myocardial infarctions after surgical treatment of a giant coronary artery fistula. The etiology was due to thrombus development in a large blind pouch, with propagation into more proximal vessels. Stenting of the proximal vessel provided temporary benefit, but recurrence eventually required surgical closure of the blind pouch.