RESUMEN
Coronary artery fistula is an uncommon congenital anomaly of the coronary arteries, and there are lots of variations. We present a-46-year-old male patient with abnormal cardiac silhouette on chest X-ray. Coronary computed tomography (CT) angiography showed coronary artery (left anterior descending artery)-to-pulmonary artery fistula with a giant aneurysm( 55 mm). Considering the risk of rupture, surgery was indicated. The patient underwent surgical repair through median sternotomy under cardiopulmorary bypass and cardiac arrest antegrade myocardial protection. Fistulas were dissected and ligated proximally and distally, then the aneuysm was resected. By flushing bloody cardioplegic solution, we confirmed that there was no residual blood inflow to the aneurysm. Post-operative course was unevenful without evidence of myocardial injury. The patient discharged home on 10th postoperative day.