Saccular aneurysm of congenital coronary arteriovenous fistula.

A rare aneurysm of a congenital coronary arteriovenous fistula is reported. Echocardiography showed a dilated left coronary and left circumflex artery with normal left anterior descending artery. A dilated structure near the crux was confirmed to be a large aneurysm of circumflex coronary artery on selective angiography. It drained into the posterior right atrial wall. Under cardiopulmonary bypass, the drainage site was identified and directly closed from within the right atrium. Fistula was ligated at origin. The diagnostic and different treatment modalities are reviewed.