[Incidence and classification diagnosis of coronary artery fistula at dual-source CT coronary angiography].

Objective: To evaluate the incidence, types and clinical significance of coronary artery fistula (CAF) on CT coronary angiography (CTCA).

Methods: A total of 48 533 consecutive patients undergoing CTCA at 4 Chinese hospitals were retrospectively analyzed. The incidence, types and clinical significance of CAF were retrospectively summarized.

Results: One hundred and two patients had CAF with the incidence of 0.21% (102/48 533). Among them, coronary to pulmonary artery fistulas were seen in 92 patients (90.2%, 92/102), coronary to right atrium fistula in 4 (3.9%, 4/102), coronary to right ventricular fistula in 2 (2.0%, 2/102), coronary to right ventricular fistula in 2 (2.0%, 2/102), coronary to left atrium fistula in 1 (1.0%, 1/102) and coronary to small cardiac vein in 1 (1.0%, 1/102). Among 92 coronary to pulmonary artery fistulas, fistulas originated from both coronary arteries in 46 patients (50.0%, 46/92), from left coronary artery in 28 (30.4%, 28/92) and right coronary artery in 11 (12.0%, 11/92) and the remaining 7 (7.6%, 7/92) coronary to pulmonary artery fistulas were associated with extracardiac communications.

Conclusion: The incidence of CAF is 0.21% with a predominance of coronary to pulmonary artery fistulas (90.2%). The most common type of CAF is coronary to pulmonary artery fistulas from both coronary arteries (50.0%). Dual source CTCA can clearly visualize types and abnormal vessels so that it plays an important role in the diagnosis and preoperative evaluation of CAF.