A rare type of congenital fistula between the left coronary artery and the right ventricle, in which the fistula was draining just above the outflow tract, is presented. The patient was operated on utilizing cardiopulmonary bypass, and the fistulous opening into the right ventricle was closed with interrupted ti-cron sutures supported with teflon pledgets. The benefits of using a cardiopulmonary bypass in these operations or at least having it on standby in the operating room are emphasized for safer closure of the fistula when needed.

Keywords: cardiac failure, congenital cardiac fistula, coronary steal syndrome, myocardial ischemia