[A case report: surgical repair of bilateral coronary artery-pulmonary artery fistula associated with mitral regurgitation, tricuspid regurgitation and severe renal dysfunction].

: The patient was a 72-year-old female who was admitted with evaluation of dyspnea on effort. On cardiac catheterization, coronary angiography showed the fistula from both RCA and LAD to the pulmonary artery and L-R shunt ratio was 37.4%, and MR and TR were found. The preoperative examination showed renal dysfunction, BUN: 61.6 mg/ml, Cr: 21. mg/ml, 24 hr Ccr: 15.2 ml/min. At the operation, the fistula was closed from the inside of the pulmonary artery and MVR (27 SJM) and TAP (Kay-Reed method) were performed associated with the intra-operative hemodialysis. The peritoneal dialysis was used for 9 days after the operation. The hemodynamics and the urination were well controlled. A successful surgical repair of bilateral coronary artery-pulmonary artery fistula associated with valvular disease and severe renal dysfunction was reported.