open access

Vol 79, No 4 (2020)
Original article
Submitted: 2019-09-13
Accepted: 2019-10-22
Published online: 2019-12-04
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Coronary artery fistulas morphology in coronary computed tomography angiography

E. Czekajska-Chehab1, M. Skoczyński1, P. Przybylski1, G. Staśkiewicz2, A. Tomaszewski3, E. Siek1, J. Kurzepa1, M. Skoczyński4, A. Drop1
·
Pubmed: 31802472
·
Folia Morphol 2020;79(4):777-785.
Affiliations
  1. 1 st Department of Radiology, Medical University of Lublin, ul. Jaczewskiego 8, 20-090 Lublin, Poland
  2. Chair and Department of Human Anatomy, Medical University of Lublin, Poland
  3. 3. Chair and Department of Cardiology, The Medical University of Lublin, 8 Jaczewskiego St, 20-954 Lublin, Poland
  4. Department of obstetrics and gynecology, Medical University of Lublin, ul. S. Staszica 16, 20-400 Lublin, Poland

open access

Vol 79, No 4 (2020)
ORIGINAL ARTICLES
Submitted: 2019-09-13
Accepted: 2019-10-22
Published online: 2019-12-04

Abstract

Background: The aim of the study was to evaluate coronary artery fistulas (CAFs) in coronary computed 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 14,308 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 2 out of 3 cases the diagnosis of CAFs 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 CAFs 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 gridlike fistulas (48.0%, comparing to 59.2% for all patients with fistulas, p = 0.001). Concomitant abnormalities were found in 13.1% of CAFs patients.

Conclusions: Computed tomography angiography has proven to be a useful tool in CAFs 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 (CAFs) in coronary computed 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 14,308 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 2 out of 3 cases the diagnosis of CAFs 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 CAFs 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 gridlike fistulas (48.0%, comparing to 59.2% for all patients with fistulas, p = 0.001). Concomitant abnormalities were found in 13.1% of CAFs patients.

Conclusions: Computed tomography angiography has proven to be a useful tool in CAFs 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 computed tomography angiography, angiography, classification

About this article
Title

Coronary artery fistulas morphology in coronary computed tomography angiography

Journal

Folia Morphologica

Issue

Vol 79, No 4 (2020)

Article type

Original article

Pages

777-785

Published online

2019-12-04

Page views

839

Article views/downloads

824

DOI

10.5603/FM.a2019.0132

Pubmed

31802472

Bibliographic record

Folia Morphol 2020;79(4):777-785.

Keywords

coronary
fistula
coronary computed tomography angiography
angiography
classification

Authors

E. Czekajska-Chehab
M. Skoczyński
P. Przybylski
G. Staśkiewicz
A. Tomaszewski
E. Siek
J. Kurzepa
M. Skoczyński
A. Drop

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