BMJ Case Reports 2012; doi:10.1136/bcr.12.2011.5333
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Traumatic left anterior descending to pulmonary trunk fistula

  1. Prakash Punjabi1
  1. 1Department of Cardiothoracics, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
  2. 2University of New South Wales, Kensington, New South Wales, Australia
  3. 3Department of Radiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
  1. Correspondence to Dr Saissan Rajendran, saissanrajendran{at}


A young man in his late 20s, presented with new-onset exertional angina. Five months earlier, the patient had presented to the trauma unit with a penetrating injury to the left chest and cardiac arrest due to cardiac tamponade. The patient had undergone emergency median sternotomy for repair of a 15 mm laceration to the right ventricular outflow tract. On examination, he had normal vital signs with no abnormal heart sounds or signs of heart failure. ECG was normal. Cardiac catheterisation demonstrated a communication between the proximal …

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