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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
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Published on: August 28, 2018

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Coronary artery changes in congenital coronary-cameral fistulas evaluated by computed tomographic angiography

Suvipaporn Siripornpitak1,2, Apichaya Sriprachyakul3,4, Worakan Promphan5

  • 1Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Phayatai, Ratchathewi, Bangkok, 10400, Thailand. ssiripornpitak@yahoo.com.

Japanese Journal of Radiology
|June 28, 2021
PubMed

Insights

Congenital coronary-cameral fistula (cCCF) often involves large coronary aneurysms. While fistula features don't predict aneurysms, closure reduces coronary artery size but carries a risk of thrombosis.

Area of Science:

  • Cardiovascular Imaging
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Congenital coronary-cameral fistula (cCCF) is a rare condition involving abnormal connections between coronary arteries and heart chambers.
  • Understanding the characteristics of cCCF and its impact on coronary arteries is crucial for effective management.

Purpose of the Study:

  • To evaluate coronary artery diameter and aneurysm prevalence in cCCF.
  • To identify factors associated with coronary artery aneurysm formation.
  • To assess changes in coronary arteries post-fistula closure using computed tomography (CT).

Main Methods:

  • Retrospective review of CT findings in 25 patients with cCCF.
  • Analysis of fistula origins, terminations, length, complexity, and Sakakibara classification.
  • Measurement of coronary artery Z scores and assessment of aneurysm presence and size.

Main Results:

  • Aneurysms were present in 52% of cases, with giant aneurysms (68%) being common.
  • No significant risk factors for aneurysm development were identified.
  • Following fistula closure, coronary artery Z scores decreased significantly (p=0.006), and coronary thrombosis occurred in 23% of patients.

Conclusions:

  • Large coronary aneurysms are a frequent finding in cCCF.
  • No specific fistula characteristics predict aneurysm formation.
  • Fistula closure leads to reduced coronary artery diameter but poses a risk of coronary thrombosis.
Abstract

Keywords:
CT coronary angiographyCongenital coronary-cameral fistulaCoronary aneurysmSurgical closureTranscatheter closure

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