Giant saccular aneurysm of coronary arteriovenous fistula to the main pulmonary artery: intraoperative assessment by using fluorescent imaging.

Coronary arteriovenous fistulas (CAF) and coronary artery aneurysms (CAA) are uncommon, but their detection has recently increased. In this case we succeeded in identifying the residual shunt flow by using an intraoperative fluorescence imaging technique with indocyanine green after surgical treatment. The photodynamic eye imaging system is based on fluorescence of indocyanine green. This is the first report to identify residual shunt flow with such a giant coronary aneurysm by using fluorescence imaging, and the result indicates that this technique is useful for acceptance as one of the examinations to evaluate CAAs. Furthermore, it may be useful for the detection of shunt cases, such as congenital heart disease.