We describe a 55-year-old female patient with multiple plexiform coronary artery-pulmonary artery fistulas, who presented with ischemic episodes accompanying an inversion of T wave on an electrocardiogram even though it was a small shunt size. The surgical procedure involved closure of the openings of the fistulas from inside the pulmonary trunk using cardiopulmonary bypass with additional ligations. Postoperative coronary angiogram revealed complete interruption of the coronary artery-pulmonary trunk fistulas resulting in complete resolution of the patient's chest symptoms.