Coronary-to-bronchial anastomoses are seen anecdotally, and their entity remains controversial (Angelini et al. 1999; Iwasaki et al. 1997; Bjork 1966; Mmoberg 1967; White et al. 1992). Several types of vascular anastomoses exist in the normal human heart, but they are not functional. When these normal anastomoses develop, they mainly represent the increase in caliber of pre-existing vessels in response to certain stimuli, such as generalized hypoxia, anemia, sustained exercise, total or partial occlusion of the coronary arteries or drugs (Esperanca and Goncalves 1981). Conversely, abnormal vascular connections are the result of various diseases, such as congenital disorders, total or partial occlusion of the coronary arteries, infection or degenerative vascular disorders. They can result in congestive heart failure, myocardial ischemia, infective endocarditis, atrial fi brillation, pulmonary hypertension and rupture.