Rupture of an aneurysm resulting from a coronary artery fistula: a case report.

A rare case of coronary-to-pulmonary artery fistulas associated with formation of a saccular aneurysm that ruptured into the pericardium occurred in a 69 year-old-female who had experienced an episode of unconsciousness 3 months earlier and who suffered a second episode. She was diagnosed as having a cardiac tamponade caused by rupture of a coronary artery aneurysm formed by a left coronary artery - pulmonary artery fistula. The hemorrhage stopped after pericardial drainage. She was referred for surgical treatment of the aneurysm and suture closure of the afferent coronary artery into the aneurysm, transpulmonary closure of the fistulas, and aneurysmorrhaphy. There was adhesion between the aneurysm and pericardium. Her postoperative course was uneventful and she has remained well for 4 months after the operation.