Congenital arteriovenous fistula complicated by arteriovenous aneurysm is very rare. We report a case of a 23-year-old man diagnosed with an asymptomatic congenital aorto-azygous fistula complicated by an arteriovenous aneurysm. Video-assisted thoracoscopic surgery (VATS) was successfully performed to resect the abnormal feeding artery and ligate the draining azygos vein. There were no postoperative complications, and late follow-up showed a satisfactory outcome. Our experience indicates that VATS is a safe and appropriate option to treat this kind of vascular malformation.
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