A 61-year-old female patient visited the local hospital 1 month before due to lumbar disc herniation and sciatic nerve compression. After treatment with “mannitol and dexamethasone” by intravenous infusion, she had dizziness, palpitations, flushing, and sweating, among other symptoms. Her blood pressure was 150/87 mm Hg, and the abovementioned symptoms lasted for about half an hour. After 3 days of infusion, the patient still experienced dizziness, palpitations, and sweating; her symptoms relieved about half an hour after administering nitroglycerin. These symptoms often occurred between 7 and 9 a.m. and had nothing to do with the patient’s daily activities or eating habits. The patient was referred to our hospital for further treatment. The electrocardiogram was normal, and transthoracic color Doppler echocardiography (TTDE) showed left coronary artery–pulmonary artery fistula and left coronary artery aneurysm dilation ( and ). Coronary angiography showed bilateral coronary artery fistula and anterior descending giant coronary aneurysm ( and , ). Coronary computed tomography angiography (CCTA) showed bilateral coronary artery–pulmonary artery fistulas with anterior descending coronary artery aneurysm ( – , ); thus, the patient underwent surgery. During the surgery, the inlet and outlet of the left and right coronary artery–pulmonary artery fistulas were fully dissociated and ligated using the lateral wall forceps to clamp the aneurysm; then, we cut open the coronary aneurysm and found the thrombosis. Finally, we closed the aneurysm stump by suture. Pathological examination was performed after aneurysm surgery ( ). We noted that the coronary artery was not clipped during the surgery. CCTA was performed again 1 week after surgery, which revealed that the coronary artery–pulmonary artery fistula and coronary artery aneurysm had disappeared ( , , ; ). Thus, the patient was discharged quickly, and no further complications occurred.
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