A 78-year-old man was admitted to hospital with heart failure and chronic bronchitis. A computed tomographic scan of the chest incidentally demonstrated bilateral abnormal vessels near the left atrium. Selective angiography showed that both internal mammary arteries and bronchial arteries communicated with the pulmonary arteries bilaterally. The patient refused surgery and was discharged on medical therapy. This is the first reported case of bilateral fistulas between the internal mammary arteries and bronchial arteries and the pulmonary arteries.
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