A 58-year-old woman was admitted to our department for evaluating an abnormal blood flow in the main pulmonary artery by transthoracic echocardiography. Coronary angiography revealed the presence of fistulas originating from the left anterior descending artery and also the right coronary artery to the main pulmonary artery. Under cardiopulmonary bypass, both fistulas were ligated near the origin, and direct closure of drainage site in the main pulmonary artery was performed. The postoperative

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... urse was uneventful, and coronary angiography after surgery showed that the coronary-to-pulmonary artery fistulas (CPAFs) disappeared. We report a surgical repair of a bilateral CPAF because the cardiac anomaly is extremely rare.