Giant coronary artery aneurysm with a fistula is a rare condition. The presence of a giant aneurysm imposes considerable health risks. We report a case of a 67-year-old woman who presented with frequent ventricular premature contractions caused by a giant coronary aneurysm arising from a branch of the left anterior descending coronary artery that had a fistulous connection to the pulmonary artery. The patient was referred for cardiac surgery. The giant aneurysm was resected, and the proximal and distal openings were closed directly. The main pulmonary artery was opened longitudinally and the fistula was also closed directly. The patient's symptoms of frequent ventricular premature contractions disappeared postoperatively as confirmed by electrocardiography. Although the standard therapeutic strategies of the disease are not well established because of the rarity of this condition, our clinical results indicate that the surgical treatment is an effective choice.
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