Traumatic right coronary artery-right ventricular fistula with retained intramyocardial bullet

Barry R. Alter, James R. Wheeling, Hal A. Martin, Joseph P. Murgo, Robert L. Treasure, George M. McGranahan

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


A case of traumatic right coronary artery-right ventricular fistula secondary to a gunshot wound is presented. In addition, the bullet was retained within the interventricular septum. The diagnostic approach, surgical findings and operative procedure of this and other reported cases are discussed. Several key points are emphasized. First, extended follow-up is necessary after trauma to the heart since fistulas may develop years after the initial injury. Second, surgery is generally indicated for fistulas although some data are presented suggesting that small to moderate fistulas may be treated medically. Third, if surgery is undertaken, very careful operative technique must be utilized to locate and close the fistula. Surgical treatment of choice may be coronary arterial ligation with a distal bypass graft if necessary. Postoperative evaluation is mandatory because fistulas may recur. Indications for removal of a foreign body within the myocardium are also discussed.

Original languageEnglish (US)
Pages (from-to)815-819
Number of pages5
JournalThe American journal of cardiology
Issue number5
StatePublished - Nov 1977

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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