Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography

In this study, we aimed to evaluate the prevalence and types of coronary artery fistulas (CAFs) with a special focus on origin, course, termination, and associated anomalies in adult patients who underwent coronary CT Angiography (CTA) at our institution. 2462 patients who underwent ECG gated coronary CTA at our institution between August 2006 and August 2020 were included. We found the records of 11 patients who had the diagnosis of CAF. The assessment included the vessels of origin, the drainage vessels, the presence of coronary artery disease, combined congenital or acquired anomalies, and the relations with the adjacent structures. The CAFs were diagnosed with coronary CTA in 11 of 2462 patients (0.44%) (7 women, 4 men; age range 35-73 years, mean=55.2 years, SD±11.38). There were 7 cases of single fistula vessel and four cases of multiple fistula vessels. Among 11 CAFs there were 17 fistula vessels involved, including 11 Left Main Coronary Artery originated vessels and six Right Coronary Artery originated vessels. There were 17 drainage sites and distribution frequency were as follows: nine cases with pulmonary artery two cases with left ventricle, two cases with right ventricle, two cases with coronary sinus, one case with the left bronchial artery, one case with left atrium. Cardiac CTA with 3D reconstruction can be used to accurately assess the complex anatomy of CAFs, including site, the number of origins and drainage sites, and associated anomalies. This information is important for planning the treatment and the followup of the patients.

Yetişkinlerde Koroner Arter Fistülleri: Koroner BT Anjiyografi ile Değerlendirme

Bu çalışmada, kurumumuzda koroner BT Anjiyografi (BTA) uygulanan erişkin hastalarda koroner arter fistüllerinin (KAF) prevalansını ve tiplerini, özellikle köken, seyir, terminasyon ve ilişkili anomalilere odaklanarak değerlendirmeyi amaçladık. Ağustos 2006-Ağustos 2020 tarihleri arasında kurumumuzda EKG-gated koroner BTA yapılan 2462 hasta çalışmaya alındı. KAF tanısı alan 11 hastanın kayıtlarını bulduk. Değerlendirme, fistül orifis ve drenajını, koroner arter hastalığının varlığını, ilişkili konjenital veya edinilmiş anomalileri ve komşu yapılarla ilişkilerini içeriyordu. 2462 hastanın 11'inde (%0.44) (7 kadın, 4 erkek; yaş aralığı 35-73 yaş, ortalama= 55.2 yaş, SD±11.38) KAF'lara koroner BTA tanısı konuldu. 7 vaka tek fistül damarı ve dört vaka birden fazla fistül damarı vardı. 11 CAF arasında, 11 Sol Ana Koroner Arter kaynaklı ve altı Sağ Koroner Arter kaynaklı dahil olmak üzere 17 fistül vardı. 17 fistüle ait drenaj bölgelerine ilişkin dağılım sıklığı şu şekildeydi: dokuz pulmoner arter, olgu iki sol ventrikül, iki sağ ventrikül, iki koroner sinüs, bir sol bronşiyal arter, bir sol atriyum. 3D rekonstrüksiyonlu kardiyak BTA; bölge, kaynak sayısı ve drenaj bölgeleri ve ilişkili anomaliler dahil olmak üzere KAF'lerin karmaşık anatomisini doğru bir şekilde değerlendirmek için güvenli ve kolay şekilde kullanılabilir. Bu bilgiler tedavi planlaması ve hastaların takibi açısından önemlidir.

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