Prevalence and types of coronary to pulmonary artery fistula in a Chinese population at dual-source CT coronary angiography

Abstract

Based on this large cohort, the prevalence of CPAF in the Chinese population is about 0.17%, with origin from either the left or right coronary artery or from both. CTCA can clearly visualize the types, abnormal vascular tracts, and aneurysmal sac formation of CPAF.

Multi-Detector CT Coronary Angiographic Findings of Coronary-to-Pulmonary Artery Fistula

“…This discrepancy with cardiac catheterization could have resulted from the difference in the modality used. In our study, 67% of CPAFs originated from both the right and left coronary arteries, which is in accordance with previous studies using CT (53-59%) (16)(17)(18)(19). The remaining 33% of CPAFs in our study originated from a single coronary artery; 25% of CPAFs originated from the LCA and 8% of CPAFs originated from the RCA.…”

Coronary Artery Fistula and Its Imaging Modalities—A Review Article

“…In the recent study done among Chinese population, the prevalence of coronary pulmonary artery fistula (CPAF) was found to be 0.17%, which is thought to be much higher than previously reported in literature [12]. Kim et al [13] reported a 0.32% prevalence of CPAF, based on their finding of 17 CPAF cases in 5372 patients.…”

“…It is assumed to be due to the fact that the cases detected incidentally during coronary artery evaluation by MDCT were abundant. The possibility for the variation in prevalence among different populations may be due to ethnic differences, and also the retrospective nature of the studies which may miss some small CPAF contribute to the differences in prevalence [12]. Most of the times, literature alludes fistula arising from RCA to be dominant.…”

“…However, some studies showed that the most common type is coronary to pulmonary artery fistula. In both these studies, MSCT angiography was done which assisted for the above findings [12] [35]. Many studies reported in the literature had proved MSCT as the best diagnostic tool.…”

Surgical Treatment of Coronary to Pulmonary Artery Fistulas in Adults

“…3) Recently, multidetector computed tomography (MDCT) has been used to delineate the complex anatomy of CAF 4) or coronary aneurysm, 5) with recent studies indicating that coronary to pulmonary artery fistulas (CPAFs) are the most common type. [6][7][8] It has been argued that the embryological basis of CPAF is different from other types of CAF, which drain into cardiac chambers, 9,10) and that the resulting left-toright shunt is relatively small through a CPAF. 11) To date, the optimal management for small and asymptomatic CPAFs remains a matter of debate.…”