A 35 years old young lady was presented with long history exertional dyspnoea and recent history of shortness of breath on daily activities. On clinical examination a continuous murmur could be heard mostly at left second intercostal space along the left parasternal area. A transthoracic color Doppler echocardiogram observed a continuous flow of color in the high parasternal short axis view, draining from proximal part of right coronary artery towards main pulmonary artery. A selective right coronary angiography demonstrates a fistulous tract communicating the proximal part of the right coronary artery with the main pulmonary trunk. This report evaluates the surgical outcome of a complex fistula involving right coronary artery and main pulmonary artery with single feeding vessel originating from the proximal part of the right coronary artery.
