The evaluation of coronary artery-to-pulmonary artery fistula in adulthood on 256-slice CT coronary angiography: Comparison with coronary catheter angiography and transthoracic echocardiography

Li, Jing Lei; Huang, Lei; Zhu, Wei; Ye, Wei Tao; Yan, Li Fen; Zhong, Xiao Mei; Luo, Hai Ying; Saboo, Sachin S.; Huang, Mei; Liang, Chun

doi:10.1016/j.jcct.2018.10.013

Cited by 10 publications

(14 citation statements)

References 18 publications

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“…Some researchers have recommended CT as the first imaging modality choice for radiologic evaluation of CPAF (20). In Zhou's study (21), the incidence of CPAF was 0.19% by CCTA, while Li reported a higher incidence of up to 0.36%, in which 20% cases were missed by CAG and 80.9% cases missed by TTE (22). In the present study, the incidence of CPAF detected by CCTA was 0.55%, and the difference compared with previous reports may be caused by the relatively small sample or inclusion criteria of CPAF for CCTA.…”

Section: Discussioncontrasting

confidence: 68%

Coronary artery-to-pulmonary artery fistula in adults: evaluation with 320-row detector computed tomography coronary angiography

Hang¹,

Zhao²,

Sui³

et al. 2021

Ann Transl Med

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Background: To analyze the imaging features of coronary artery-to-pulmonary artery fistula (CPAF) on coronary computed tomography angiography (CCTA).Methods: This was a retrospective study of 3,975 patients who underwent 320 row detector CCTA examinations in our hospital from May 2015 to July 2020. A total of 22 patients who diagnosed with CPAF were reviewed for CCTA imaging characteristics, including the origin, number, blood volume, opening size, and course of fistula vessels, and the drainage site, size, and imaging features of the fistula. All cases were analyzed for the presence of coronary atherosclerotic plaque and that of deficient left ventricular myocardial perfusion.Results: A total of 22 CPAF cases detected by CCTA were collected (men, 11; women, 11; median age, 59.6±10.1 years). There were 7, 10, and 5 cases detected with 1, 2, and 3 fistula vessels, respectively, among which 4 originated from the left coronary artery, 4 from the right coronary artery, and 14 had bilateral origins. There were 10 cases in which the fistula vessels presented as a worm-like tortuous dilation with (n=5) or without (n=5) aneurysm, while 12 cases showed malformed vascular networks with (n=8) or without (n=4) aneurysm, respectively. The calculated incidence of aneurysm formation was 59.09%, and fistula vessels with an aneurysm had larger blood volume than those without. All fistula showed a single drainage site, with an average diameter of 2.81±1.48 mm where the diameter of fistula with aneurysm was larger than that without.The fistula vessels drained into the left anterolateral and anterior walls of main pulmonary artery and the proximal left inferior PA, respectively. Typical jet sign, smoke sign, and isodensity sign were presented in 22, 14 and 1 case, respectively. For the coexistent abnormalities analyzed in 22 cases, 17 participants with CPAF demonstrated hypoperfusion of the fistula vessels, and 11 demonstrated calcified plaque accompanied with luminal stenosis to different degrees. Conclusions:The 320-row detector CCTA can comprehensively characterize the morphological features of CPAF, which is an optimal choice for physicians to make an accurate assessment before formulating patient management strategies.

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Section: Discussioncontrasting

confidence: 68%

Coronary artery-to-pulmonary artery fistula in adults: evaluation with 320-row detector computed tomography coronary angiography

Hang¹,

Zhao²,

Sui³

et al. 2021

Ann Transl Med

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“…Imaging findings of coronary artery fistula in adults have been frequently described in the literature [ 3 4 6 7 8 9 12 13 14 ], while imaging findings of coronary artery fistula in children have been rarely reported [ 5 15 ]. Therefore, this paper aimed to illustrate the detailed imaging findings of coronary artery fistula in children.…”

Section: Introductionmentioning

confidence: 99%

Imaging Findings of Coronary Artery Fistula in Children: A Pictorial Review

Goo

2021

Korean J Radiol

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Coronary artery fistula, defined as an abnormal communication between the coronary arteries and a cardiac chamber (most commonly) or a thoracic great vessel, may result in hemodynamically significant problems due to vascular shunting in children. Echocardiography, cardiac catheterization, cardiac MRI, and cardiac CT may be used to evaluate coronary artery fistula in children. Recently, CT has played a pivotal role for the accurate diagnosis of coronary artery fistula in children. Surgical or interventional treatment is performed for hemodynamically significant coronary artery fistulas. In this pictorial review, the detailed imaging findings of coronary artery fistula in children are described.

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“…Coronary artery-to-pulmonary artery fistula (CPAF) is a rare coronary artery anomaly defined as the abnormal communication between the coronary artery and pulmonary artery [1]. It mostly remains asymptomatic before incidentally discovered by coronary computed tomography angiography (CCTA) [2].…”

Section: Introductionmentioning

confidence: 99%

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

Guo

Dong

et al. 2021

BMC Cardiovasc Disord

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Background Coronary artery-to-pulmonary artery fistula is a rare disorder characterized by abnormal vascular communication between the coronary artery and pulmonary artery. While most patients remain asymptomatic, some might exhibit symptoms of myocardial ischemia, congestive heart failure, or even sudden cardiac death if coronary aneurysm, thrombosis, infective carditis, or other congenital cardiac defects coexist. Case presentation We present a 66-year-old male complaining of angina pectoris with a history of hypertension and active smoking. He was diagnosed with a coronary aneurysm based on coronary computed tomography angiography. We subsequently identified a coronary artery-to-pulmonary artery fistula with giant aneurysmal dilation on coronary angiography. Ultimately we conducted surgery ligation and aneurysmorrhaphy. During surgery, we discovered newly formed thrombus within the aneurysmal cavity. Histological analysis of the aneurysmal wall supported the diagnosis of the congenital disorder. Our patient was successfully discharged and remained asymptomatic at two months of follow-up. Conclusion We presented a rare and complex combination of congenital coronary artery-to pulmonary artery fistula, giant coronary aneurysmal dilatation, and thrombosis through multi-modality evaluations.

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The evaluation of coronary artery-to-pulmonary artery fistula in adulthood on 256-slice CT coronary angiography: Comparison with coronary catheter angiography and transthoracic echocardiography

Cited by 10 publications

References 18 publications

Coronary artery-to-pulmonary artery fistula in adults: evaluation with 320-row detector computed tomography coronary angiography

Coronary artery-to-pulmonary artery fistula in adults: evaluation with 320-row detector computed tomography coronary angiography

Imaging Findings of Coronary Artery Fistula in Children: A Pictorial Review

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

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