Coronary artery fistula: Comparison of diagnostic accuracy by echocardiography versus coronary arteriography and surgery in 63 patients studied between 2002 and 2012 in a single medical center in China
| Autor: | Ling Li, Zhenxing Sun, Li Yuan, Qing Lv, Xinfang Wang, Hua Peng, Li Zhang, Jing Wang, Tsung O. Cheng, Mingxing Xie |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male China medicine.medical_specialty Adolescent Fistula Coronary Vessel Anomalies Young Adult Internal medicine medicine Humans Child Coronary sinus Aged Retrospective Studies business.industry Angiography Infant Newborn Infant Coronary arteriography Middle Aged Coronary artery fistula medicine.disease Surgery Cardiac surgery Coronary arteries medicine.anatomical_structure Echocardiography Ventricle Child Preschool Cardiology Female Radiology Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | International Journal of Cardiology. 176:470-477 |
| ISSN: | 0167-5273 |
| Popis: | Background Coronary artery fistula (CAF) is a rare congenital anomaly, which is conventionally diagnosed by coronary arteriography; however, the relation of the coronary artery fistulas to other structures, their origin and course may not be always apparent. Methods The echocardiograms of 63 patients with coronary artery fistulas, who had undergone coronary arteriography and/or surgery from June 2002 to December 2012 at the Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, were analyzed retrospectively, and the results were compared with findings by coronary arteriography and at surgery. Results Right CAFs were detected in 33 of the 63 patients (52.4%); 11 had drainage to the right atrium, 10 to the right ventricle, 2 to the left ventricle, 9 to the main pulmonary artery, and 1 to the coronary sinus. Left CAFs were detected in 29 patients (46.0%); 6 had drainage to the right atrium, 12 to the right ventricle, 1 to the left atrium, 2 to the left ventricle, 7 to the main pulmonary artery, and 1 to the coronary sinus. One patient (1.6%) had the origin of the fistula in both coronary arteries. The entry point of the fistula was most often a single orifice (96.8%) and rarely multi-orificial (3.2%). 57 patients (90.5%) had isolated coronary fistulas (90.5%); 6 patients (9.5%) had other congenital cardiac malformations. The ultrasonic diagnosis of 60 patients was in line with findings at surgery and/or coronary arteriography. The diagnostic accuracy rate for coronary artery fistula was 95.2%. Preoperative transthoracic echocardiography missed the diagnosis of coronary artery fistula in three patients (4.8%). There is no difference (P>0.05) in diagnostic accuracy between echocardiography and coronary arteriography and/or surgery. Conclusions Transthoracic echocardiography, in comparison with coronary arteriography and/or surgery, is much simpler, easier, less expensive, safer, readily repeatable, and more convenient with equal accuracy, and should be the first-line method for the diagnosis of congenital coronary artery fistula. |
| Databáze: | OpenAIRE |
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