A Retrospective Analysis: CCTA vs. TTE in Diagnosing Coronary Artery Fistula

This study aimed to compare and analyze the diagnostic performance of cardiac computed tomographic angiography (CCTA) and transthoracic echocardiography (TTE) for coronary artery fistula (CAF) and evaluate the effectiveness of these two imaging modalities.

We retrospectively collected and analyzed imaging data from 200 patients diagnosed with CAF through surgery or digital subtraction angiography (DSA). These patients underwent CCTA and TTE examinations in our hospital. Finally, the course, origin, number, size, and location of the CAF in all patients were assessed. The diagnostic results of CCTA were compared with those of TTE, using DSA and/or surgical diagnosis as the reference standard.

Among the 200 patients with CAF, CCTA correctly diagnosed 156 cases, but missed 44 cases, resulting in a diagnostic accuracy of 78.0% (156/200). In contrast, TTE accurately diagnosed 55 cases, but missed 145 cases, yielding a diagnostic accuracy of 27.5% (55/200). The diagnostic accuracy of CCTA was significantly higher than that of TTE in detecting CAF (P < 0.001).

CCTA demonstrated significantly greater diagnostic value than TTE, demonstrating to be the preferred imaging modality for diagnosing CAF.