Anastomosis of an Internal Mammary Artery to the Anterior Cardiac Vein

We present the case of a 65-year-old man who had undergone coronary artery bypass surgery 12 years previously. He presented with recurrent cardiac chest pain. Repeat coronary angiography showed anastomosis of the left internal mammary artery to the anterior cardiac vein. There was no evidence of a fistula formation. In conclusion, incorrect anastomosis of conduits is rare in cardiac surgery but should be considered, especially in the presence of symptoms or sign of fistula formation.