A case of four coronary artery fistulae originating from three vessels associated with aneurysm

A case of an aneurysm associated with four coronary artery fistulaeoriginating from three vessels is reported. The patient, a 52-year-oldwoman, had chest heaviness and palpitations. Coronary arteriographyreveaed the four fistulae originating from three coronary vesselswith an aneurysm draining into the left ventricle and the mainpulmonary artery.The patient's symptoms were relieved afterfistulectomy and the aneurysmectomy, suggesting that a coronarysteal phenomenon through the fistulae was the cause of her symptoms.This case is of interest because of its rarity, since this isthe first case report of an aneurysm associated with four coronaryartery fistulae from three vessels.