Echocardiograpy and 64-MSCTA in Diagnosing Coronary Artery Fistula

Purpose: To evaluate echocardiograpy and 64-Multi-slice computed tomography angiography (64-MSCTA) in diagnosing coronary artery fistula (CAF). Methods: the data of 15 patients with CAF confirmed by surgical operation or digital subtraction angiography (DSA) were retrospectively analyzed. All the patients were examined by echocardiograpy, of whom 4 were further examined by 64-MSCTA for more detailed anatomic and lesion information before surgery. Their imaging features of CAF were discussed. Results: In the 15 patients with CAF, 12 were correctly diagnosed with echocardiograpy, of whom 4 were further confirmed with 64-MSCTA. 3 cases were missed diagnosis with echocardiograpy, of which 1 with two fistulae. The origins of CAF were from the left coronary artery in 9, from the right in 7. The draining sites were the right heart in 8, pulmonary artery in 5, left heart in 2 and aorta in 1. Both echocardiograpy and 64-MSCTA showed the origin, fistula and drainage site of CAF. Besides, echocardiograpy showed the abnormal blood flow of a fistula and 64-MSCTA showed the whole CAF, its calcification and peripheral structure. Conclusion: Echocardiograpy can act as the routine examination of CAF, and 64-MSCTA can provide more detailed anatomic and pathologic information than echocardiograpy for surgery.