先天性冠狀動靜脈　管是相當罕見的先天性心臟疾病。年輕人的症狀可能相當輕微或甚至於完全沒有症狀，有些人則可能伴隨著其他解剖學上的異常。雖然其他的非侵入性診斷方式不斷進步，動脈攝影仍然是診斷的主要標準及作為治療的參考準則。手術及經導管栓塞皆是治療此先天性疾病的選擇。最終的治療方式有賴於　管的精確解剖位置分佈。我們在這?報告一個病人同時患有先天性巨大瘤狀右側冠狀動脈及另一個源自左側環狀枝的動靜脈?管;且此兩動靜脈?管同時終止於冠狀靜脈竇。因為擔心不預期性的栓塞脫離而造成其他部位的梗塞，最後我們選擇以手術作為治療的方式。此病患於術後情況良好且症狀亦獲得緩解。

Coronary arteriovenous fistula is a rare congenital cardiac anomaly. Symptoms may be mild or absent in young patients, and some are associated with other anatomic anomalies. Angiography remains the gold standard for diagnosis and a guide to therapy, although other noninvasive modalities are increasingly useful. Both surgery and coil embolism are options for correcting this anomaly. The final choice, however, depends on the precise anatomic distribution of the fistula. Here we report a patient who had a giant aneurysm-like right coronary artery resulting from a fistula terminating in the coronary sinus and another fistula arising from the circumflex artery. Surgical ligation was chosen over coil embolism to prevent unintended distal embolism. The patient underwent a successful operation and no longer experienced her previous symptoms.