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.