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Acquired left coronary artery to left atrium fistula: unusual complication of aortocoronary bypass.

This report describes a very unusual complication of aortocoronary bypass graft surgery. It consists of the formation of an acquired fistula between the left circumflex coronary artery and the left atrium in a patient who was operated two years prior to its clinical presentation. Significant coronary steal gave rise to disabling angina and prompted a second operation to close the fistula. The diagnosis was made with selective arteriogram that clearly delineated the fistulous tract and surgery was accomplished without extracorporeal circulation.