Iatrogenic coronary artery fistula that developed during septal myectomy was detected intraoperatively through transesophageal echocardiography.

This letter discusses the case of a 50-year-old man with obstructive hypertrophic cardiomyopathy (HOCM) who underwent a septal myectomy (the Morrow procedure). During the procedure, a coronary artery fistula was detected using transesophageal echocardiography (TEE) during terminal warm blood cardioplegia infusion. The TEE allowed for the intraoperative detection of the fistula, which was later confirmed to have closed spontaneously after the surgery. The authors emphasize the importance of TEE in detecting and assessing coronary artery fistulas during the Morrow procedure. [Extracted from the article]