Transpulmonary closing of left internal mammary artery to pulmonary artery fistula with polytetrafluoroethylene covered stent: a case report and review of literature.

Internal mammary artery (IMA) to pulmonary vasculature fistula is a rare condition that can be congenital or associated with coronary artery bypass grafting surgery (CABG), trauma, inflammation, or neoplasia. This complication may cause myocardial ischemia. CABG with an IMA conduit accounts for most iatrogenic cases, thus this problem may be encountered more in the future as the number of patients undergoing CABG and redo-CABG increases. The natural history of IMA-to-pulmonary artery (PA) fistulas is unknown and therefore optimal treatment remains controversial. We describe a case of left IMA-to-PA fistula treated with balloon expandable covered stent with a transpulmonary approach, and we review previously reported cases.