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An S-shaped sinoatrial nodal artery coronary artery fistula demonstrated by multidetector CT

R Macduff1, G H Roditi

  • 1Department of Radiology, The Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF. rossmacduff@nhs.net

The British Journal of Radiology
|January 13, 2011
PubMed

Insights

CT coronary angiography effectively visualized an unusual coronary artery fistula in a patient with myocardial infarction. This imaging technique accurately mapped the fistula

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology
  • Anatomical Pathology

Background:

  • Coronary artery fistulae are rare congenital or acquired abnormalities.
  • Accurate anatomical depiction is crucial for diagnosis and management.
  • CT coronary angiography offers high-resolution imaging of coronary anatomy.

Observation:

  • A 41-year-old male presented with acute myocardial infarction.
  • Invasive coronary angiography identified an incidental coronary artery fistula but failed to delineate its course.
  • CT coronary angiography was performed to precisely define the fistula's anatomy.

Findings:

  • CT coronary angiography successfully depicted a fistulous connection between the left circumflex artery and the superior vena cava.
  • The fistula followed the anatomical course of a sinoatrial nodal artery.
  • This confirmed the utility of CT coronary angiography in complex coronary artery anomalies.

Implications:

  • CT coronary angiography is a valuable tool for characterizing coronary artery fistulae, especially complex or unusual ones.
  • Enhanced anatomical understanding can guide treatment strategies for patients with coronary artery anomalies.
  • This case underscores the diagnostic capabilities of CT coronary angiography in revealing intricate coronary artery anatomy.

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