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Coronary artery fistula: estimation of shunt using 99m Tc-albumin particles
Insights
A coronary artery fistula was diagnosed in a 60-year-old man using myocardial radioisotopic scanning. Surgical ligation of the fistula was successful, demonstrating a novel application for this diagnostic technique.
Area of Science:
- Cardiology
- Nuclear Medicine
- Diagnostic Imaging
Background:
- Coronary artery fistulas are rare congenital or acquired abnormalities.
- Angina pectoris can be a symptom of significant coronary artery fistulas.
Observation:
- A 60-year-old male presented with angina pectoris.
- A fistula between the left main coronary artery and the main pulmonary artery was identified.
Findings:
- Myocardial radioisotopic scanning with 99mTc-Albumin demonstrated a left-to-right shunt of 56% of left coronary artery flow.
- Successful surgical ligation of the coronary artery fistula was performed without complications.
Implications:
- This case highlights a novel application of myocardial radioisotopic scanning for diagnosing coronary artery fistulas.
- Accurate diagnosis and surgical intervention can effectively resolve symptoms associated with coronary artery fistulas.
Abstract:
A 60-year-old man presented with complaints on angina pectoris and was found to have a coronary artery fistula between his left main truck and main pulmonary artery. Particles of 99m Tc-Albumin were injected in the ostium of the left coronary artery, and differential radioactive counts were injected in the ostium of the left coronary artery, and differential radioactive counts were obtained over both lung fields and myocardium. The degree of left to right shunt was calculated at 56% of total left coronary artery flow. The patient underwent ligation of the fistula without any complications. This case report represents a new application of myocardial radioisotopic scanning.