ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
The role of multislice computed tomography in the diagnosis of coronary artery fistulas
Seviye Bora Şişman1, Demet Doğan1, Sinan Şahin1, Hasan Şahan2, Ayşe Emre3
1Department of Radiology, University of Health Sciences Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
2Department of Radiology, Sinop State Hospital, Sinop, Turkey
3Department of Cardiology, University of Health Sciences Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Turkey
DOI : 10.5606/tgkdc.dergisi.2018.14321
Background: This study aims to investigate the frequency and the anatomical features of coronary artery fistulas in patients undergoing multislice computed tomographic angiography for various reasons.

Methods: Between January 2009 and July 2015, a total of 40 coronary artery fistulas of 26 patients were retrospectively analyzed using multislice computed tomographic angiography in our clinic. The affected arteries and localizations of the fistulas were evaluated.

Results: Of the fistulas, 11 (27.5%) were originating from the circumflex artery, 10 (25%) from the left anterior descending artery, four (10%) from the diagonal arteries, three (7.5%) from the left main coronary artery, three (7.5%) from the right main coronary artery, three (7.5%) from the septal artery, three (7.5%) from the conus artery, one (2.5%) from the obtuse marginal artery, one (2.5%) from left anterior descending artery proper (dual LAD), and one (2.5%) from the ramus intermedius. One of the conus arteries was directly originating from the right coronary sinus. Twelve (30%) of the fistulas were draining into the pulmonary trunk, eight (20%) into the left ventricle, seven (17.5%) into the right ventricle, five (12.5%) into the superior vena cava, three (7.5%) into the right main pulmonary artery, two (5%) into the right atrium, one (2.5%) into the left atrium, one (2.5%) into the right internal thoracic artery, and one (2.5%) into the sinus coronarius.

Conclusion: Compared to conventional angiography, multislice computed tomographic angiography is a non-invasive modality which allows enhancing coronary artery fistulas at a higher rate and visualizing the cardiac anatomy in detail.

Keywords : Coronary artery; fistula; multislice computed tomographic angiography
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