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ORIGINAL ARTICLES
Published online: 2019-12-04
Submitted: 2019-09-13
Accepted: 2019-10-22
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Coronary artery fistulas morphology in coronary computed tomography angiography

Elżbieta Czekajska-Chehab, Marcin Skoczyński, Piotr Przybylski, Grzegorz Staśkiewicz, Andrzej Tomaszewski, Elżbieta Siek, Joanna Kurzepa, Mariusz Skoczyński, Andrzej Drop
DOI: 10.5603/FM.a2019.0132
·
Pubmed: 31802472

open access

Ahead of Print
ORIGINAL ARTICLES
Published online: 2019-12-04
Submitted: 2019-09-13
Accepted: 2019-10-22

Abstract

Background: The aim of the study was to evaluate coronary artery fistulas (CAF) in coronary tomography angiography (coronary CTA) and verify whether there is correlation between the fistula’s morphology and other cardiac functional findings and clinical data.

Materials and methods: A group of 14308 patients who were diagnosed in coronary CTA was retrospectively analysed. Achieved data were related to referrals.

Results: Coronary artery fistula frequency was 0.43% in the examined population. The assessment of coronary artery disease was the most frequent indication for the examination. In two out of three cases the diagnosis of CAF was incidental. Fistulas to cardiac chambers were significantly shorter than those to other vascular structures (19.9 vs 61.8 mm respectively, p=0.001). Pulmonary trunk was most often the drainage site. Fistulas with singular supply and drainage constituted the majority. The new morphologic classification of coronary artery fistulas was introduced with linear, spiral, aneurysmal, grid-like and mixed types. Most numerous was the spiral type group. Patients with aneurysmal fistulas had a tendency for wider diameter of aorta and pulmonary trunk. Smallest left ventricle fraction was observed in grid-like fistulas (48.0%, comparing to 59.2% for all patient with fistulas, p=0.001). Concomitant abnormalities were found in 13.1% of CAF patients.

Conclusions: Computed tomography angiography has proven to be a useful tool in coronary artery fistulas detection and morphological assessment. Proposed classification may simplify the predictions whether fistula has a significant influence on cardiac function, however further studies are needed.

Abstract

Background: The aim of the study was to evaluate coronary artery fistulas (CAF) in coronary tomography angiography (coronary CTA) and verify whether there is correlation between the fistula’s morphology and other cardiac functional findings and clinical data.

Materials and methods: A group of 14308 patients who were diagnosed in coronary CTA was retrospectively analysed. Achieved data were related to referrals.

Results: Coronary artery fistula frequency was 0.43% in the examined population. The assessment of coronary artery disease was the most frequent indication for the examination. In two out of three cases the diagnosis of CAF was incidental. Fistulas to cardiac chambers were significantly shorter than those to other vascular structures (19.9 vs 61.8 mm respectively, p=0.001). Pulmonary trunk was most often the drainage site. Fistulas with singular supply and drainage constituted the majority. The new morphologic classification of coronary artery fistulas was introduced with linear, spiral, aneurysmal, grid-like and mixed types. Most numerous was the spiral type group. Patients with aneurysmal fistulas had a tendency for wider diameter of aorta and pulmonary trunk. Smallest left ventricle fraction was observed in grid-like fistulas (48.0%, comparing to 59.2% for all patient with fistulas, p=0.001). Concomitant abnormalities were found in 13.1% of CAF patients.

Conclusions: Computed tomography angiography has proven to be a useful tool in coronary artery fistulas detection and morphological assessment. Proposed classification may simplify the predictions whether fistula has a significant influence on cardiac function, however further studies are needed.

Get Citation

Keywords

coronary, fistula, coronary CTA, angiography, classification

About this article
Title

Coronary artery fistulas morphology in coronary computed tomography angiography

Journal

Folia Morphologica

Issue

Ahead of Print

Published online

2019-12-04

DOI

10.5603/FM.a2019.0132

Pubmed

31802472

Keywords

coronary
fistula
coronary CTA
angiography
classification

Authors

Elżbieta Czekajska-Chehab
Marcin Skoczyński
Piotr Przybylski
Grzegorz Staśkiewicz
Andrzej Tomaszewski
Elżbieta Siek
Joanna Kurzepa
Mariusz Skoczyński
Andrzej Drop

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