Araştırma Makalesi
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Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography

Yıl 2021, Cilt: 8 Sayı: 2, 104 - 108, 31.08.2021

Öz

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 follow-up of the patients.

Destekleyen Kurum

Yok

Teşekkür

Thanks to Dr.Nuri Serdar BAŞ and Yeliz Türksever for their support during the preparation of the article.

Kaynakça

  • 1. Sommer RJ, Hijazi ZM, Rhodes JF. Pathophysiology of congenital heart disease in the adult: part III: Complex congenital heart disease. Circulation. 2008;117(10):1340-50. Erratum in: Circulation. 2009;119(21):e547.
  • 2. Mangukia CV. Coronary artery fistula. Ann Thorac Surg. 2012;93(6):2084-92.
  • 3. Latson LA. Coronary artery fistulas: how to manage them. Catheter Cardiovasc Interv. 2007;70(1):110-6.
  • 4. Said SA, el Gamal MI, van der Werf T. Coronary arteriovenous fistulas: collective review and management of six new cases--changing etiology, presentation, and treatment strategy. Clin Cardiol. 1997;20(9):748-52.
  • 5. Koenig PR, Kimball TR, Schwartz DC. Coronary artery fistula complicating the evaluation of Kawasaki disease. Pediatr Cardiol. 1993;14(3):179-80.
  • 6. Manes MT, Pavan D, Chiatto M, et al. Fistola coronarica congenita isolata in età adulta: descrizione di un caso e revisione della letteratura [Isolated congenital coronary fistula in adult population: discussion a clinical case and review of current literature]. Monaldi Arch Chest Dis. 2007;68(4):235-8.
  • 7. Zenooz NA, Habibi R, Mammen L, et al. Coronary artery fistulas: CT findings. Radiographics. 2009;29(3):781-9.
  • 8. Lim JJ, Jung JI, Lee BY, et al. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. AJR Am J Roentgenol. 2014;203(3):237-43.
  • 9. Challoumas D, Pericleous A, Dimitrakaki IA, et al. Coronary arteriovenous fistulae: a review. Int J Angiol. 2014;23(1):1-10.
  • 10. Buccheri D, Chirco PR, Geraci S, et al. Caramanno G, Cortese B. Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies. Heart Lung Circ. 2018;27(8):940-51.
  • 11. Zhou K, Kong L, Wang Y, et al. Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography. Br J Radiol. 2015;88(1049):20140754.
  • 12. de Jonge GJ, van Ooijen PM, Piers LH, et al. Visualization of anomalous coronary arteries on dual-source computed tomography. Eur Radiol. 2008;18(11):2425-32.
  • 13. Datta J, White CS, Gilkeson RC, et al. Anomalous coronary arteries in adults: depiction at multi-detector row CT angiography. Radiology. 2005;235(3):812-8.
  • 14. Saboo SS, Juan YH, Khandelwal A, et al. MDCT of congenital coronary artery fistulas. AJR Am J Roentgenol. 2014;203(3):244-52.
  • 15. Baltaxe HA, Wixson D. The incidence of congenital anomalies of the coronary arteries in the adult population. Radiology. 1977;122(1):47-52.
  • 16. van den Brand M, Pieterman H, Suryapranata H, et al. Closure of a coronary fistula with a transcatheter implantable coil. Cathet Cardiovasc Diagn. 1992;25(3):223-6.
  • 17. Yiginer O, Bas S, Feray H. Demonstration of coronary-to-pulmonary fistula with MDCT and conventional angiography. Int J Cardiol. 2009;134(3):126-8.
  • 18. Gowda RM, Vasavada BC, Khan IA. Coronary artery fistulas: clinical and therapeutic considerations. Int J Cardiol. 2006;107(1):7-10.
  • 19. Yoshimura N, Hamada S, Takamiya M, et al. Coronary artery anomalies with a shunt: evaluation with electron-beam CT. J Comput Assist Tomogr. 1998;22(5):682-6.
  • 20. Ropers D, Moshage W, Daniel WG, et al. Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction. Am J Cardiol. 2001;87(2):193-7.
  • 21. Zenooz NA, Habibi R, Mammen L, et al. Coronary artery fistulas: CT findings. Radiographics. 2009;29(3):781-9.
  • 22. Yun G, Nam TH, Chun EJ. Coronary Artery Fistulas: Pathophysiology, Imaging Findings, and Management. Radiographics. 2018;38(3):688-703. Erratum in: Radiographics. 2018;38(7):2214.
  • 23. Dodd JD, Ferencik M, Liberthson RR, et al. Evaluation of efficacy of 64-slice multidetector computed tomography in patients with congenital coronary fistulas. J Comput Assist Tomogr. 2008;32(2):265-70.

etişkinlerde Koroner Arter Fistülleri: Koroner BT Anjiyografi ile Değerlendirme

Yıl 2021, Cilt: 8 Sayı: 2, 104 - 108, 31.08.2021

Öz

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.

Kaynakça

  • 1. Sommer RJ, Hijazi ZM, Rhodes JF. Pathophysiology of congenital heart disease in the adult: part III: Complex congenital heart disease. Circulation. 2008;117(10):1340-50. Erratum in: Circulation. 2009;119(21):e547.
  • 2. Mangukia CV. Coronary artery fistula. Ann Thorac Surg. 2012;93(6):2084-92.
  • 3. Latson LA. Coronary artery fistulas: how to manage them. Catheter Cardiovasc Interv. 2007;70(1):110-6.
  • 4. Said SA, el Gamal MI, van der Werf T. Coronary arteriovenous fistulas: collective review and management of six new cases--changing etiology, presentation, and treatment strategy. Clin Cardiol. 1997;20(9):748-52.
  • 5. Koenig PR, Kimball TR, Schwartz DC. Coronary artery fistula complicating the evaluation of Kawasaki disease. Pediatr Cardiol. 1993;14(3):179-80.
  • 6. Manes MT, Pavan D, Chiatto M, et al. Fistola coronarica congenita isolata in età adulta: descrizione di un caso e revisione della letteratura [Isolated congenital coronary fistula in adult population: discussion a clinical case and review of current literature]. Monaldi Arch Chest Dis. 2007;68(4):235-8.
  • 7. Zenooz NA, Habibi R, Mammen L, et al. Coronary artery fistulas: CT findings. Radiographics. 2009;29(3):781-9.
  • 8. Lim JJ, Jung JI, Lee BY, et al. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. AJR Am J Roentgenol. 2014;203(3):237-43.
  • 9. Challoumas D, Pericleous A, Dimitrakaki IA, et al. Coronary arteriovenous fistulae: a review. Int J Angiol. 2014;23(1):1-10.
  • 10. Buccheri D, Chirco PR, Geraci S, et al. Caramanno G, Cortese B. Coronary Artery Fistulae: Anatomy, Diagnosis and Management Strategies. Heart Lung Circ. 2018;27(8):940-51.
  • 11. Zhou K, Kong L, Wang Y, et al. Coronary artery fistula in adults: evaluation with dual-source CT coronary angiography. Br J Radiol. 2015;88(1049):20140754.
  • 12. de Jonge GJ, van Ooijen PM, Piers LH, et al. Visualization of anomalous coronary arteries on dual-source computed tomography. Eur Radiol. 2008;18(11):2425-32.
  • 13. Datta J, White CS, Gilkeson RC, et al. Anomalous coronary arteries in adults: depiction at multi-detector row CT angiography. Radiology. 2005;235(3):812-8.
  • 14. Saboo SS, Juan YH, Khandelwal A, et al. MDCT of congenital coronary artery fistulas. AJR Am J Roentgenol. 2014;203(3):244-52.
  • 15. Baltaxe HA, Wixson D. The incidence of congenital anomalies of the coronary arteries in the adult population. Radiology. 1977;122(1):47-52.
  • 16. van den Brand M, Pieterman H, Suryapranata H, et al. Closure of a coronary fistula with a transcatheter implantable coil. Cathet Cardiovasc Diagn. 1992;25(3):223-6.
  • 17. Yiginer O, Bas S, Feray H. Demonstration of coronary-to-pulmonary fistula with MDCT and conventional angiography. Int J Cardiol. 2009;134(3):126-8.
  • 18. Gowda RM, Vasavada BC, Khan IA. Coronary artery fistulas: clinical and therapeutic considerations. Int J Cardiol. 2006;107(1):7-10.
  • 19. Yoshimura N, Hamada S, Takamiya M, et al. Coronary artery anomalies with a shunt: evaluation with electron-beam CT. J Comput Assist Tomogr. 1998;22(5):682-6.
  • 20. Ropers D, Moshage W, Daniel WG, et al. Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction. Am J Cardiol. 2001;87(2):193-7.
  • 21. Zenooz NA, Habibi R, Mammen L, et al. Coronary artery fistulas: CT findings. Radiographics. 2009;29(3):781-9.
  • 22. Yun G, Nam TH, Chun EJ. Coronary Artery Fistulas: Pathophysiology, Imaging Findings, and Management. Radiographics. 2018;38(3):688-703. Erratum in: Radiographics. 2018;38(7):2214.
  • 23. Dodd JD, Ferencik M, Liberthson RR, et al. Evaluation of efficacy of 64-slice multidetector computed tomography in patients with congenital coronary fistulas. J Comput Assist Tomogr. 2008;32(2):265-70.
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular İç Hastalıkları
Bölüm Araştırma Makalesi
Yazarlar

Serap Baş 0000-0002-3607-0620

Yayımlanma Tarihi 31 Ağustos 2021
Gönderilme Tarihi 28 Kasım 2020
Yayımlandığı Sayı Yıl 2021 Cilt: 8 Sayı: 2

Kaynak Göster

APA Baş, S. (2021). Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, 8(2), 104-108.
AMA Baş S. Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography. MMJ. Ağustos 2021;8(2):104-108.
Chicago Baş, Serap. “Coronary Artery Fistulas in Adults: Evaluation With Coronary CT Angiography”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8, sy. 2 (Ağustos 2021): 104-8.
EndNote Baş S (01 Ağustos 2021) Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8 2 104–108.
IEEE S. Baş, “Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography”, MMJ, c. 8, sy. 2, ss. 104–108, 2021.
ISNAD Baş, Serap. “Coronary Artery Fistulas in Adults: Evaluation With Coronary CT Angiography”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi 8/2 (Ağustos 2021), 104-108.
JAMA Baş S. Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography. MMJ. 2021;8:104–108.
MLA Baş, Serap. “Coronary Artery Fistulas in Adults: Evaluation With Coronary CT Angiography”. Muğla Sıtkı Koçman Üniversitesi Tıp Dergisi, c. 8, sy. 2, 2021, ss. 104-8.
Vancouver Baş S. Coronary Artery Fistulas in Adults: Evaluation with Coronary CT Angiography. MMJ. 2021;8(2):104-8.