Detachable balloon embolization of an iatrogenic aortocoronary arteriovenous fistula combined with aortocoronary bypass PTCA: a case report.

Coronary artery bypass surgery was performed in a 54-year-old male, and one of the grafts was inadvertently sutured to the vena cordis magna instead of to the left anterior descending coronary artery (LAD). Four years later the patient observed a progression of symptoms including episodes of angina pectoris at rest. Coronary angiography showed stenosis of one of the bypass grafts and notable dilatation of an iatrogenic arteriovenous (A-V) fistula. The stenosed bypass graft was dilated and the A-V fistula occluded by use of a detachable balloon. Embolization was performed rather than surgery, as the LAD was found to be a poor surgical target. The patient's symptoms improved after the procedure; he was followed for 18 months during which time his condition remained stable.