Internal Mammary Artery Graft Fistulae to the Pulmonary Arteries as a cause of Myocardial Ischaemia after Coronary Artery Bypass Graft

Abstract Internal mammary artery (IMA) graft fistula to the pulmonary arteries is a cause of myocardial ischaemia after coronary artery bypass grafting (CABG). Surgical and percutaneous interventional treatments are available, both with their inherent risk and benefits. Optimised medical management is therefore essential. A pre CABG IMA angiographic image may assist surgeons to ligate identifiable accessory branches, which may contribute to fistula formation.