Coronary artery fistulas in children

Hu, Xihong; Wu, Lin; Liu, F.; Shen, Quanli; Modesti, Pietro Amedeo; Huang, Guoying

doi:10.1007/s00059-013-3786-2

Cited by 4 publications

(5 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our findings are consistent with previous studies conducted by Sherwood et al, 10 Lim et al 11 and Kim et al 12 Sherwood et al 10 found that the majority of symptomatic CAFs originated from the RCA, whilst asymptomatic CAFs had a greater prevalence of origin from the LCA; moreover, Lim et al 11 found that coronary to pulmonary artery fistula (CPAF) accounts for 76.8% of cases, and Kim et al 12 found CPAF to account for 89.5% of CAFs. By contrast, Hu et al 9 found that 70% of CAFs in children (mean age, 2.9 years) originated from the RCA.…”

Section: Discussionmentioning

confidence: 90%

See 1 more Smart Citation

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

Zhou

Kong²,

Y³

et al. 2015

BJR

View full text Add to dashboard Cite

Conclusion: Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF commonly originates from LCA or both LCA and RCA in adults. DSCT is a robust tool for investigating the origin, course and drainage site of CAF and coexistent abnormalities. Advances in knowledge: A large adult patient cohort who underwent DSCT angiography was reviewed to assess CAFs. Coronary-pulmonary artery fistula in adults was found more often than in previous studies. CAF was observed to originate from the LCA or both coronary arteries in adults. DSCT could clearly depict the fistula origin, course, drainage site and coexisting abnormalities. Conventional angiography results, treatments and followup DSCT images were analysed.Coronary artery fistulas (CAFs) are anomalous connections of the coronary arteries. The phenomenon was first described in 1865 by Krause. 1 CAF is considered as a major coronary anomaly by Ogden's classification.2 Most CAFs are congenital. CAFs have an estimated prevalence of 0.002% in the general population; however, they are present in 0.05-0.25% of patients who undergo coronary angiography.3-5 The traditional diagnosis tool for CAFs is conventional angiography. With the advent of 64-slice multidetector CT in chest and cardiac imaging, the number of incidentally found CAFs has been increasing. The advanced electrocardiogram (ECG)-gated technique of dual-source CT (DSCT) could provide high diagnostic accuracy for the assessment of coronary artery disease.According to prior studies, CAF arises from the right coronary artery (RCA) in approximately 50% of patients. [6][7][8] In particular, 70% of the CAFs in children (mean age, 2.9 years) originated from the RCA. 9 In this study, we focused on adult patients. A large cohort of adult patients who underwent DSCT angiography was reviewed to assess CAFs. The CAFs and coexisting abnormalities were analysed. METHODS AND MATERIALS PatientsA total of 17,548 patients who were suspected of having coronary artery disease underwent contrast-enhanced CT angiography (CCTA) from January 2008 to October 2013 in Peking Union Medical College Hospital, Beijing, China. The CCTA reports and images were retrospectively reviewed. Four experienced radiologists reviewed the axial, maximum intensity projection and volume rendering technique images of all 17,548 patients through the picture archiving and communication system. All the images were reviewed only once because of the large amount of work.

show abstract

Section: Discussionmentioning

confidence: 90%

“…[6][7][8] In particular, 70% of the CAFs in children (mean age, 2.9 years) originated from the RCA. 9 In this study, we focused on adult patients. A large cohort of adult patients who underwent DSCT angiography was reviewed to assess CAFs.…”

mentioning

confidence: 99%

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

Zhou

Kong²,

Y³

et al. 2015

BJR

View full text Add to dashboard Cite

show abstract

“…CAF formation is attributed to the persistence of abnormal sinusoidal connections to cardiac structures and can involve connection to a cardiac chamber (coronary-cameral fistula) or to a central venous structure (coronary arteriovenous fistula) [5-7]. Although Case 2 demonstrated a fistula originating from the left coronary sinus, Hu et al found that 70 % of CAFs in children (mean age 2.9 years) originate from the RCA [8]. The most common sites for fistulous connections are the right ventricle, right atrium, and pulmonary artery [9].…”

Section: Discussionmentioning

confidence: 99%

Anomalous Coronary Anatomy with Fistula Diagnosed on Coronary Computed Tomography Angiography

Butt

Agha

Parente

et al. 2019

Cureus

View full text Add to dashboard Cite

Anomalous coronary vasculature is a rare finding among the general population. Identifying such cases is important for preventing adverse outcomes such as sudden cardiac death. We present two rare cases of aberrant coronary anatomy. In Case 1, a 4-year-old male who presented with non-exertional chest pain was found to have anomalous coronary architecture on echocardiogram. Coronary computed tomography angiogram (CCTA) confirmed an anomalous origin of the left coronary artery from the right coronary sinus with a malignant interarterial course and myocardial bridging of the left anterior descending (LAD) artery. The patient underwent a successful surgical correction of the defects. In Case 2, a full-term infant female was born with a hypoplastic right ventricle and pulmonary atresia. CCTA showed a large fistula originating from the coronary sinus on the left that drained into the superior aspect of the mid right ventricular cavity, an anomalous bridge between the left and right atrial appendages, and five fistulous connections between various vessels. The patient was transferred to another facility for cardiac transplant.

show abstract

“…A recent study (31) showed that intramural segments in anomalous coronary arteries with interarterial course can be identified on coronary CT angiography by demonstrating acute angle of origin, slit-like orifice, and elliptical cross-sectional shape with vessel height/width ratio greater than 1.3. Coronary artery fistula is defined as a direct precapillary connection between a coronary artery and a low-pressure system, such as the right cardiac chamber, pulmonary artery, or coronary sinus, resulting in a usually small left-to-right shunt (32, 33, 34, 35). Coronary artery fistula is generally asymptomatic in adults, while it is often symptomatic in pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

“…Coronary artery fistula usually occurs in isolation but may occur in complex congenital heart disease, such as pulmonary atresia and intact ventricular septum in which myocardial ischemia may be developed due to the so-called right ventricle-dependent coronary circulation (35). Coronary CT angiography provides detailed angioarchitecture of coronary artery fistula and its spatial relationship with the nearby major cardiovascular structures, which is necessary for optimal treatment planning (32, 33, 34, 35). In addition to hemodynamically significant anomalies, hemodynamically benign coronary artery anomaly, such as high take-off, may be clinically significant at cardiac surgery (28, 36) (Fig.…”

Section: Introductionmentioning

confidence: 99%

Coronary Artery Imaging in Children

Goo

2015

Korean J Radiol

View full text Add to dashboard Cite

Coronary artery problems in children usually have a significant impact on both short-term and long-term outcomes. Early and accurate diagnosis, therefore, is crucial but technically challenging due to the small size of the coronary artery, high heart rates, and limited cooperation of children. Coronary artery visibility on CT and MRI in children is considerably improved with recent technical advancements. Consequently, CT and MRI are increasingly used for evaluating various congenital and acquired coronary artery abnormalities in children, such as coronary artery anomalies, aberrant coronary artery anatomy specific to congenital heart disease, Kawasaki disease, Williams syndrome, and cardiac allograft vasculopathy.

show abstract

Coronary artery fistulas in children

Abstract: Coronary 64-slice MDCT angiography depicted the whole shape and course of the CAF as well as of the surrounding structures. It may serve as a noninvasive diagnostic tool when planning a therapeutic strategy.

Cited by 4 publications

References 23 publications

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography

Anomalous Coronary Anatomy with Fistula Diagnosed on Coronary Computed Tomography Angiography

Coronary Artery Imaging in Children

Contact Info

Product

Resources

About