Prenatal diagnosis of tetralogy of Fallot associated with a fistula from the left coronary artery to the left atrium

Khan, Mohammed D.; Sivasubramonian, Sivasankaran; Simpson, John

doi:10.1017/s1047951103000362

Cited by 12 publications

(12 citation statements)

References 9 publications

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“…6 Only one report described the prenatal diagnosis of a large fistula from the left coronary artery to the left atrial appendage in TOF, with congestive cardiac failure postnatally and death after surgical correction of TOF with ligation of the fistula at 3 months of age. 7 We did not find the association of TOF, coronary-pulmonary artery fistulas, and agenesis of the ductus arteriosus as described in the present case. The fistula was only diagnosed at autopsy, but prenatally, we found a discrepancy between the narrow pulmonary annulus with a thickened pulmonary valve with minimal flow at 22 weeks and the pulmonary trunk that was adequately developed.…”

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confidence: 73%

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Tetralogy of Fallot with coronary artery to pulmonary artery fistula

et al. 2014

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What's already known about this topic?Coronary artery fistulas are rare anomalies with an incidence of 0.002% in the population. What does this study add?The association of tetralogy of Fallot, coronary artery fistulas, and agenesis of the ductus arteriosus has not been reported.The discrepancy between the narrow pulmonary annulus with thickened pulmonary valve and the large pulmonary trunk can be caused by extra blood supply through the large fistula.

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confidence: 73%

“…Only one report described the prenatal diagnosis of a large fistula from the left coronary artery to the left atrial appendage in TOF, with congestive cardiac failure postnatally and death after surgical correction of TOF with ligation of the fistula at 3 months of age …”

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confidence: 99%

Tetralogy of Fallot with coronary artery to pulmonary artery fistula

et al. 2014

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“…1 The case was associated with preterm labor and severe intrauterine growth restriction and was followed by a sudden cardiorespiratory arrest. In comparison with our case, it appears that an RCA fistula connecting to the RV has a better clinical outcome because postnatal cardiac output is dependent on the left heart function.…”

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confidence: 99%

“…Most often, a fistula from the right coronary artery (RCA) to the right ventricle (RV) occurs in association with pulmonary atresia, but coronary fistulas without pulmonary stenosis have been reported. 1 We report the case of a prenatal diagnosis of an isolated RCA fistula to the RV. …”

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confidence: 98%

Prenatal Diagnosis of a Right Coronary-Cameral Fistula

Hung

Hung³

et al. 2006

Journal of Ultrasound in Medicine

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congenital coronary-cameral fistula involves an abnormal fistulous connection between a coronary artery and a cardiac chamber. Most often, a fistula from the right coronary artery (RCA) to the right ventricle (RV) occurs in association with pulmonary atresia, but coronary fistulas without pulmonary stenosis have been reported. 1 We report the case of a prenatal diagnosis of an isolated RCA fistula to the RV. Case ReportA fetus at a gestational age of 20 weeks 4 days was referred for echocardiography because of a questionable congenital cardiac anomaly detected during a routine obstetric scan. An asymmetric 4-chamber view with a markedly enlarged right heart was first scanned ( Figure 1A). A turbulent flow from the lateral margin of the right heart back into the RV was shown in a 4-chamber view ( Figure 1B). The pulmonary artery (1.38 cm) and aortic root (1.12 cm) on the 3 great-vessel views ( Figure 1C) were disproportionate in size. In the short axis view of the aortic root, the origins of the left and right coronary arteries were found to be dilated ( Figure 1D), which was further shown with power Doppler imaging (Figure 2A). Power Doppler imaging also showed the dilated RCA and its connection with the RV through a fistulous tract ( Figure 2B). The 3-dimensional function on power Doppler sonography also showed the RCA fistula ( Figure 2C). Color Doppler flow imaging confirmed the presence of to-and-fro flow across the fistula near its insertion into the RV ( Figure 2D). We did follow-up sonographic examinations on the fetus every 2 to 3 weeks. The progressive dilatation of the RCA was recorded. The size of the RCA at its opening from the aortic root was 0.38 cm at 20 weeks 4 days; it was 0.661 cm at 37 weeks 1 day. Fetal tachycardia as high as 176 beats/min was recorded at the first sonographic scan-

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“…The exception would be congenital coronary artery anomalies that lead to significant dilation of the coronary arteries and/or lead to abnormal flow from the coronary arteries into a cardiac chamber or great vessel. These situations hold in cases of coronary-cameral fistulae, and these abnormalities have occasionally been noted on prenatal echocardiograms [8,9]. …”

Section: Prenatal Assessmentmentioning

confidence: 95%

Congenital Anomalies of the Coronary Arteries

Herlong

2009

Echocardiography in Pediatric and Congenital Heart Disease

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The term coronary derives from the Latin root coronarius, which means crown. Indeed, the coronary arteries sit on the heart as a crown, and they are the "crowning subject" of adult cardiology due to the prevalence of acquired coronary artery disease. Although less of a preeminent subject in pediatric cardiology, coronary artery anomalies, with and without concomitant structural congenital heart disease, are an important topic for the pediatric cardiologist. This chapter reviews echocardiography of congenital coronary artery anomalies of importance to the pediatric cardiologist. Material pertinent to all congenital coronary artery anomalies is presented first, followed by material particular to each important anomaly. Developmental considerationsBefore the development of the coronary arteries, the loosely packed myocardium of the embryonic heart is nourished by sinusoids throughout the heart cavities. As the myocardium becomes more compact, veins, arteries and capillaries develop from these primitive sinusoids. Then, at around 32 days of gestation, subepicardial vascular networks develop; shortly thereafter, endothelial buds appear at the base of the truncus arteriosus. These two anlagen join to one another by around 45 days of gestation, and the definitive coronary arterial circulation is thus established.Controversy exists regarding the number of endothelial buds present at the base of the truncus arteriosus and the manner in which the two coronary anlagen (subepicardial vascular networks and endothelial buds) connect with one another. Abrikossoff originally described two endothelial buds that were "allotted" to the aorta by division of the truncus into aorta and pulmonary artery [1]. Hackensellner later suggested that there are endothelial buds in each of the six sinuses of Valsalva of the great arteries and that all but two of these ultimately involute [2]. The latter theory has better withstood subsequent investigation [3], but either theory may readily explain the multitude of coronary artery anomalies that exist. The method of involution and induction of the appropriate sinuses of Valsalva remains speculative [4]. Normal coronary anatomyThere are normally two major coronary arteries, which originate from the right and left aortic sinuses of Valsalva. These sinuses are small outpouchings of the aorta between the sinotubular junction and the aortic valve leaflets. There are normally three such sinuses; the third, or posterior, sinus of Valsalva, is usually devoid of a coronary artery orifice. It is thus called the noncoronary sinus of Valsalva. The left coronary arteryThe left main coronary artery arises from the left sinus of Valsalva and courses only a short distance (<4 cm in the adult) before dividing into the left circumflex and left anterior descending coronary arteries (Fig. 29.1). The left circumflex coronary artery varies considerably in size depending on whether the posterior descending coronary artery is a branch of the right coronary artery (right-dominant coronary system) or a branch of the circu...

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Prenatal diagnosis of tetralogy of Fallot associated with a fistula from the left coronary artery to the left atrium

Cited by 12 publications

References 9 publications

Tetralogy of Fallot with coronary artery to pulmonary artery fistula

Tetralogy of Fallot with coronary artery to pulmonary artery fistula

Prenatal Diagnosis of a Right Coronary-Cameral Fistula

Congenital Anomalies of the Coronary Arteries

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