Pulmonary atresia with ventricular septal defect (PA-VSD) is a congenital complex cardiac anomaly. The blood supply to the lungs can be from patent ductus arteriosus (PDA), major aortopulmonary collateral artery (MAPCA) or in very rare cases from coronary artery-pulmonary artery fistula (CAPAF). We had coronary artery-pulmonary artery fistula (CAPAF) in 2 patients which had surgical intervention. In our first patient which was operated 10 years ago, the main pulmonary artery had a source from LMCA. In second patient, the right pulmonary artery derived from LMCA and advanced to the right lung from the posterior of the aorta and the left pulmonary artery was coming out of the PDA.