Preoperative evaluation of coronary artery fistula using dual-source computed tomography

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• 作者：Ke Shi^a ; ¹ ; Hong-ling Gao^b ; ¹ ; Zhi-gang Yang^a ; ² ; ^{yangzg666@163.com} ; Qin Zhang^a ; Xi Liu^a ; Ying-kun Guo^c ; ² ; ^{gykpanda@163.com}
• 关键词：Congenital heart disease ; Coronary artery fistula ; Computed tomography
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 February 2017
• 年：2017
• 卷：228
• 期：Complete
• 页码：80-85
• 全文大小：999 K
• 卷排序：228

文摘

To evaluate the efficacy of dual-source computed tomography (DSCT) in assessing the morphological features, quantitative features, and associated coronary artery lesions among patients with coronary artery fistula (CAF) before surgery.MethodsWe enrolled 34 patients with CAF that were morphologically and quantitatively analyzed by DSCT and compared the analyses with surgical results (reference standard). The associated coronary artery lesions were also assessed.ResultsBy DSCT, we identified 15 patients (44.1%) with left-sided CAF, 9 (26.5%) with right-sided CAF, and 10 (29.4%) with bilateral CAF; the left anterior descending coronary artery (50.0%) was most frequently involved. Drainage was most commonly in the main pulmonary artery (41.2%), and those with right-sided CAF had larger feeding coronary arteries and drainage sites than those with left-sided or bilateral CAF (p < 0.05). All the morphological features presented by DSCT were confirmed at surgery. In the quantitative analysis of CAF, DSCT was as accurate as surgery (r = 0.95–0.98, p < 0.001), and it was able to evaluate associated lesions accurately, including arteriosclerotic plaques, coronary artery aneurysms, and myocardial bridges. The evaluation could be completed in a single scan, without requiring an increased radiation dose (mean ED = 2.27 ± 1.92 mSv).ConclusionsDSCT is an alternative noninvasive imaging method that enables accurate assessment of morphological features, quantitative features, and associated coronary artery lesions in patients with CAF. It can be used to provide comprehensive information for determining surgical strategies.