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[Imaging feature of computed tomography angiography in patients with coronary artery fistulas]

Shan Yang1, Meng-su Zeng, Hong Yun

  • 1Department of Radiology, Zhongshan Hospital of Fudan University, Shanghai 200032, China.

Zhonghua Xin Xue Guan Bing Za Zhi
|December 16, 2011
PubMed

Insights

Coronary artery fistulas are common, often draining into the pulmonary artery. Coronary artery computed tomography angiography (CTA) is a reliable initial diagnostic tool, providing essential information for treatment planning.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Coronary artery fistulas (CAFs) are abnormal connections between coronary arteries and heart chambers or vessels.
  • Diagnosis and characterization of CAFs are crucial for appropriate management.

Purpose of the Study:

  • To analyze the computed tomography angiography (CTA) features of coronary artery fistulas.
  • To evaluate the diagnostic utility of CTA in identifying CAF origin, drainage, and associated coronary artery disease.

Main Methods:

  • Retrospective analysis of 12,717 patients who underwent coronary artery multiple detector CTA.
  • Sixty-six cases of coronary artery fistulas were identified and analyzed for origin, drainage, plaque, and stenosis.
  • Coronary angiography (DSA) was performed in 14 patients for comparison.

Main Results:

  • Coronary artery fistulas originated from the left coronary artery (26), right coronary artery (19), and bilateral systems (21).
  • The pulmonary artery was the most frequent drainage site (41 cases), followed by the left atrium (10), right atrium (8), left ventricle (4), coronary sinus (2), and right ventricle (1).
  • CTA findings correlated well with DSA in 14 patients. Coronary artery plaque was present in 31 cases, with significant stenosis (>50%) in 7.

Conclusions:

  • Coronary artery fistulas are not rare, with the pulmonary artery being the most common drainage site.
  • Coronary artery CTA is a valuable first-line diagnostic tool for suspected CAFs.
  • CTA provides comprehensive information essential for therapeutic decision-making.
Abstract

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