Stress MIBI scintigraphy in multiple coronary-pulmonary fistula: failure to demonstrate “steal” phenomenon

Said, S.A.M.; Bucx, J. J. J.; Weel, F.A. van de

doi:10.1016/0167-5273(92)90189-a

Cited by 12 publications

(6 citation statements)

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“…When adult patients are evaluated, the possibility of acquired as well as congenital coronary arteriovenous fistulas has to be taken into account. Clinically, the two conditions can "Clinical and follow-up data of cases 5-19 have been the subject of earlier reports [ 2,7,19,20,23,35,36,38]. bRCA = right coronary artery; LAD = left anterior descending coronary artery; CX = circumflex coronary artery.…”

Section: Discussionmentioning

confidence: 99%

“…In the selected series of Giannroccoano et al [34], transesophaged echocardiography confirmed the presence of coronary artery anomalies detected by angiography and helped to locate the course and drainage site of CAVFs. CAVFs associated with intracardiac tumor are rare [35] and multiple fistulas are even rarer [36]. Although these abnormalities have been associated with longevity [37,38], the spontaneous resolution of CAVF is rare.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical findings and long-term, follow-up data of the fifteen reported patients have been published elsewhere [2,7,19,20,23,35,36,38]. Coronary angiographic findings of all 19 patients (23 CAVFs) are presented in Table I.…”

Section: Methodsmentioning

confidence: 99%

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Coronary angiographic morphology of congenital coronary arteriovenous fistulas in adults: Report of four new cases and review of angiograms of fifteen reported cases

Said

Gamal

1995

Cathet. Cardiovasc. Diagn.

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The coronary angiographic features of four new cases of congenital coronary arteriovenous fistulas (CAVFs) are described, and the angiograms of 15 reported cases are reviewed. The morphologic appearance of CAVFs varied from a small discrete single channel to a highly complex plexiform network with a maze of fine vessels. The majority of CAVFs in our series were composed of a single channel. Aneurysmal formation was present in 26% (6/23). Aneurysmal formation involved only the pathway and/or the termination, but never originated from the beginning of the CAVFs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Coronary angiographic morphology of congenital coronary arteriovenous fistulas in adults: Report of four new cases and review of angiograms of fifteen reported cases

Said

Gamal

1995

Cathet. Cardiovasc. Diagn.

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“…Although previous studies using myocardial perfusion scintigraphy in patients with CAF reported prevalence of ischemia ranging between 30.4% and 55% [ 19 , 20 ], few studies reported the prevalence of ischemia with a significant number of patients with CPAF using myocardial perfusion scintigraphy. Only a few cases reported the usefulness of stress/rest myocardial perfusion single photon emission tomography (SPECT) in CPAF [ 21 – 24 ].…”

Section: Introductionmentioning

confidence: 99%

Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT

Lee

Jung

et al. 2017

PLoS ONE

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ObjectivesWith the increasing use of multi-detector CT, the number of detected cases with coronary-to-pulmonary artery fistula (CPAF) has increased. Several previous studies reported severe cases of angina, but no appropriate tests to evaluate myocardial perfusion for patients with CPAF have been established. We evaluated the hemodynamic characteristics of CPAF using thallium-201 (Tl-201) single photon emission computed tomography (SPECT).Materials and methodsTl-201 SPECT was performed in 17 patients with CPAF, but without evidence of coronary artery disease on coronary computed tomography angiography (CCTA) (age, 58.5±13.3 years; 8 men). Quantitative analysis of scintigraphic data was performed. Additionally, perfusion abnormalities were compared with CCTA findings. Medical records were obtained to define clinical data, diagnostic findings, symptoms, management, follow-up data, and major adverse cardiac events (MACE).ResultsSix patients (35.2%) showed perfusion abnormalities on SPECT studies and could be classified as follows: 3 patients, no reversible ischemia (3/17, 17.6%); 1 patient, mild ischemia (1/17, 5.8%); and 2 patients, moderate ischemia (2/17, 11.7%). During the follow-up, ten patients (58.8%) improved under medical management and 5 patients (29.4%) underwent surgical ligation for CPAF with symptomatic improvement in 4 patients. Seven patients performed follow-up myocardial perfusion SPECT, and symptomatic improvement correlated well with scintigraphic perfusion improvement in 6 patients No MACE was observed.Clinical significanceTl-201 myocardial perfusion SPECT might be useful for determining the hemodynamic status and for risk stratification in patients with CPAF.

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“…The majority of these anomalies involve only 1 coronary artery, and only rarely are 2 coronary arteries involved. [1][2][3][4][5] It has been reported that approximately 5% of all coronary artery fistulas occur bilaterally. 1 Bilateral coronary artery fistulas usually communicate with a single site in a cardiac chamber or vascular structures, and fistulas with multiple sites of drainage are extremely rare.…”

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Bilateral Coronary Artery Fistulas With Multiple Sites of Drainage

Yasuma¹,

Takata

Yuasa³

et al. 1998

Jpn Circ J

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coronary artery fistula is an uncommon congenital malformation of the heart. The majority of these anomalies involve only 1 coronary artery, and only rarely are 2 coronary arteries involved. [1][2][3][4][5] It has been reported that approximately 5% of all coronary artery fistulas occur bilaterally. 1 Bilateral coronary artery fistulas usually communicate with a single site in a cardiac chamber or vascular structures, and fistulas with multiple sites of drainage are extremely rare. This report describes a very rare case of bilateral coronary artery fistulas draining into the main pulmonary artery, the great cardiac vein and the right atrium. Case ReportA 49-year-old woman was referred to hospital for evaluation of a cardiac murmur. On admission, her blood pressure was 148/82 mmHg. The pulse rate was 68 beats/min and regular. A high-pitched continuous murmur of grade 3/6 was heard best in the third intercostal space at the left sternal border. The laboratory data were all normal. The electrocardiogram was normal as was the chest X-ray. No significant ST-T wave changes were found at a maximal heart rate of 181 beats/min during treadmill exercise testing. Stress thallium-201 myocardial scintigraphy showed no perfusion defects.At cardiac catheterization, the pressures, cardiac output and left ventricular function were all normal. Selective coronary arteriography revealed no fixed narrowing of any coronary artery, but showed 4 coronary artery fistulas. One fistula originated from the proximal part of the left coronary anterior descending coronary artery and connected to the main pulmonary artery (Fig 1). Three coronary artery Japanese Circulation Journal Vol.62, October 1998 fistulas arising from a conal branch of the right coronary artery also were noted (Fig 2). These fistulas drained into the main pulmonary artery, the right atrium and the great cardiac vein. The calculated pulmonary-to-systemic flow ratio (Qp/Qs) was 1.3:1.0. She received no medication and advice for endocarditis prophylaxis was given. DiscussionThe actual incidence of bilateral coronary fistulas is not known. Levin et al reviewed 363 cases of coronary fistulas and noted that such fistulas were single in the majority of cases, and only 19 cases (5%) were multiple, originating from both coronary arteries. 1 The coronary artery fistulas drained into the right ventricle in 41%, the right atrium in 26%, and the pulmonary artery in 17% of their cases. Coronary artery fistulas to the cardiac chambers arise dueJpn Circ J 1998; 62: 783 -784 (Received May 13, 1998; revised manuscript received July 1, 1998; accepted July 10, 1998) A 49-year-old woman presented with bilateral coronary fistulas with multiple sites of drainage. She had been referred to hospital for evaluation of a cardiac murmur, and a coronary arteriogram revealed multiple coronary fistulas. One fistula originated from the proximal part of the left anterior descending coronary artery and connected to the main pulmonary artery. Three coronary artery fistulas arised from a conal branc...

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Stress MIBI scintigraphy in multiple coronary-pulmonary fistula: failure to demonstrate “steal” phenomenon

Cited by 12 publications

References 5 publications

Coronary angiographic morphology of congenital coronary arteriovenous fistulas in adults: Report of four new cases and review of angiograms of fifteen reported cases

Coronary angiographic morphology of congenital coronary arteriovenous fistulas in adults: Report of four new cases and review of angiograms of fifteen reported cases

Coronary-to-pulmonary artery fistula in adults: Evaluation with thallium-201 myocardial perfusion SPECT

Bilateral Coronary Artery Fistulas With Multiple Sites of Drainage

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