Post Closure Evaluation of Coronary Artery Fistulae
Post Closure Evaluation of Coronary Artery Fistulae
DOI:
https://doi.org/10.70284/njirm.v5i5.808Keywords:
MDCT, Coronary Artery Fistulae, Follow-upAbstract
Coronary artery fistula (CAF) is a rare congenital anomaly in which a communication is present between a coronary artery and cardiac chamber. Conventional coronary angiography is an invasive and expensive procedure, and cannot provide three-dimensional data. ECG gated multidetector CT (MDCT) is useful for non-invasive evaluation of coronary artery fistulae. Objectives: In this paper, we describe ten post-closure cases of coronary artery fistulae. The aim of this study is to demonstrate the effectiveness of 128 slice-MDCT in demonstrating the precise anatomy and post closure follow-up of coronary artery fistula. Methods: 10 pediatric subjects underwent MDCT as well as conventional coronary angiography. Good quality images were obtained in all patients to analyze the coronary artery fistulae and their anatomic course. Results: MDCT not only provided precise details of post closure CAF but also clearly delineated anatomy of other coronary arteries. Catheter-related risks like bleeding at puncture site, hematoma formation were completely eliminated. Advances in Knowledge: MDCT may provide additional precise details of CAF. It also eliminates minor as well as more serious complications of catheter angiography and a small but definite incidence of mortality. The procedure is carried out as an outpatient procedure. Thus, MDCT is considered as a good alternative to echocardiography and coronary angiography for diagnosis as well as follow-up of CAF. [Patel D NJIRM 2014; 5(5):82-89]
References
2. Coronary Artery Fistulas: CT Findings-Navid A. Zenooz, Reza Habibi, LeenaMammen, J. Paul Finn, Robert C. Gilkeson, RadioGraphics 2009; 29:781–789 • Published online 10.1148/rg.293085120.
3. GowdaRM, Vasavada BC, Khan IA. Coronary artery fistulas: clinical and therapeutic considerations. Int J Cardiol2006; 107(1): 7–10.
4. Ramo OJ, Totterman KJ, Harjula AL: Thrombosed coronary artery fistula as a cause of paroxysmal atrial filbrillation and ventricular arrhythmia. CardiovascSurg 1994, 2:720-722.
5. Bauer HH, Allmendinger PD, Flaherty J, Owlia D, Rossi MA, Chen C: Congenital
6. coronaryarteriovenous fistula: spontaneous rupture and cardiac tamponade.
7. Ann ThoracSurg 1996, 62:1521-1523.
8. YUN Hong, ZENG Meng-su, YANG Shan, JIN Hang and YANG Xue - Congenital coronary artery fistulas: dual-source CT findings from consecutive 6624 patients with suspected or confirmed coronary - Chin Med J 2011;124(24):4172-4177
9. SaidSA, Lam J, van der Werf T. Solitary coronary artery fistulas: a congenital anomaly in children and adults. Congenit Heart Dis2006; 1(3): 63–76.
10. Levin DC, Fellows KE, Abrams HL. Hemodynamically significant primary anomalies of the coronary arteries: angiographic aspects. Circulation. 1978;58:25–34
11. Gupta-Malhotra M. Coronary artery fistulas. Available from: http://emedicine medscape com/article/895749-overview, 2010.
12. Nakayama Y, Shikawa A, Ayusawa Y, Hosoda S et al. (2010). Surgical repair of complicated coronary arteriovenous fistula and coronary artery aneurysm in an elderly patient after 26 years of conservative therapy. Heart Vessels, Vol.26, No.1 pp. 111-116, ISSN: 1615-2573
13. Dodd JD, Ferencik M, Liberthson RR, Nieman K et al. Evaluation of efficacy of 64-slice multidetector computed tomography in patients with congenital coronary fistulas. J Comput Assist Tomogr 2008; 32:265–270
14. Zhu XY, Zhang DZ, Han XM, Cui CS, et al. (2010). Transcatheter Closure of Congenital Coronary Artery Fistulae: Immediate and Long-Term Follow-Up Results. ClinCardiol, Vol.32, No.9, pp.506–512, ISSN: 1932-8737