Electron beam CT diagnosis of coronary artery fistula: the clinical values

Objective: To study the electron beam CT (EBCT) findings of coronary artery fistula. Methods: EBCT findings of 10 cases of coronary artery fistula proved by surgery were studied retrospectively. The series included 7 male and 3 female patients, aged from 2 to 55 years (48 years in average). Enhanced scan in single slice mode was performed. Results: EBCT revealed dilated and tortuous right coronary artery in 6 patients out of 7. Among those 6 patients a communication between the right coronary artery and the enlarged ventricular cavity was detected in 5 patients, while in the rest patient the proximal right coronary artery was connected with pulmonary trunk. EBCT revealed that coronary artery fistula was from the left coronary artery in 4 patients. In a case, the left dilated and calcified diagonal branch was communicated to the left ventricle. The left conical branch connected with pulmonary trunk in 2 cases. In another case the dilated and calcified major left coronary artery and its circumflex branch were revealed, and the latter went across the pre-left atrial space into the right atrium through the posterior wall. Conclusion: Coronary artery fistula is the first consideration when EBCT demonstrates an abnormal communication between the dilated and tortuous coronary artery or its branch and cardiac chamber or blood vessel