Introduction:
The pulmonary fistula is an abnormal connection between the pulmonary artery or its branches and the pulmonary veins or left atrium bypassing the pulmonary capillary bed, which causes a right to left shunt and is considered a rare congenital cardiac malformation (1). Patients suffering from pulmonary fistula have often symptoms of central cyanosis and clubbing, and in case of delayed treatment, patients may develop embolisms, cerebrovascular accidents, or other systemic symptoms (1, 2).
Fewer than 100 cases regarding pulmonary fistulas are published in the medical literature so far (3), and among them there are only 3 published cases of pulmonary artery and left atrium fistulas(4).
This case was difficult to diagnose based on clinical and echocardiographic findings only. Usually, it need a contrast Echo and angiography or a multi-slice CT that is capable of providing the structural anatomy of the right pulmonary artery and its branches and the pulmonary veins and their relationship with the left atrium. It also helps to classify this kind of deformity; hence, we have chosen this appropriate option to repair the deformity. These kind of cases can be manage by surgical closure of the fistula or by device closure using cardiac catheterization (5).
We present here a successful surgical closure of fistula between the right pulmonary artery and the left atrium using a biological patch in a child suffering with central cyanosis.