Minimally invasive surgery in the treatment of triple vessel coronary artery disease with coexisting coronary artery fistula.

Coexistence of triple vessel coronary artery disease with coronary-pulmonary artery fistula is extremely rare. Minimally invasive cardiac surgery in the treatment of such coexisting disease is so far not reported. This case report emphasizes the feasibility of performing complete revascularization of the coronaries with coronary artery fistula ligation through a minimally invasive anterior thoracotomy, obviating full sternotomy.