Incidental congenital coronary artery vascular fistulas in adults:Evaluation with adenosine-13N-ammonia PET-CT  

作　　者：Salah AM Said Aly Agool Arno HM Moons Mounir WZ Basalus Nils RL Wagenaar Rogier LG Nijhuis Jutta M Schroeder-Tanka Riemer HJA Slart 

机构地区：[1]Department of Cardiology,Hospital Group Twente,Almelo-Hengelo 7555 DL,Overijssel,The Netherlands [2]Department of Nuclear Medicine,Hospital Group Twente,Almelo-Hengelo 7555 DL,Overijssel,The Netherlands [3]Department of Cardiology,Slotervaart Hospital,Amsterdam 1066 EC,North Holland,The Netherlands [4]Department of Cardiology,Hospital Onze Lieve Vrouwe Gasthuis,Location West,Amsterdam 1061 AE,North Holland,The Netherlands [5]Department of Nuclear Medicine and Molecular Imaging,University Medical Center Groningen,Groningen 9713 GZ,The Netherlands [6]Faculty of Science and Technology,Biomedical Photonic Imaging,University of Twente,Enschede 7522 NB,The Netherlands

出　　处：《World Journal of Cardiology》2018年第10期153-164,共12页世界心脏病学杂志（英文版）（电子版）

摘　　要：AIM To assess the functionality of congenital coronary artery fistulas(CAFs) using adenosine stress ^(13)N-ammonia positron emission tomography computed tomography(PET-CT).METHODS Congenital CAFs were incidentally detected during coronary angiography(CAG) procedures in 11 adult patients(six males and five females) with a mean age of 64.3 years(range 41-81). Patients were collected from three institutes in the Netherlands. The characteristics of the fistulas(origin, pathway and termination), multiplicity of the origins and pathways of the fistulous vessels were assessed by CAG. Five patients underwent adenosine pharmacologic stress ^(13)N-ammonia PET-CT to assess myocardial perfusion and the functional behavior of the fistula. RESULTS Eleven patients with 12 CAFs, 10 unilateral and one bilateral, originating from the left anterior descending coronary artery(n = 8), right coronary artery(n = 2) and circumflex(n = 2). All fistulas were of the vascular type, terminating into either the pulmonary artery(n = 11) or coronary sinus(n = 1). The CAG delineated the characteristics of the fistula(origin, pathway and termination). Multiplicity of the origins and pathways of the fistulous vessels were common in most fistulas(8/12, 67% and 9/12, 75%, respectively). Multiplicity was common among the different fistula components(23/36, 64%). Adenosine pharmacologic stress ^(13)N-ammonia PET-CT revealed normal myocardial perfusion and ejection fraction in all but one patient, who showed a reduced ejection fraction.CONCLUSION PET-CT may be helpful for assessing the functional status of congenital CAFs in selected patients regarding clinical decision-making. Studies with a larger patient series are warranted.AIM To assess the functionality of congenital coronary artery fistulas(CAFs) using adenosine stress ^(13)N-ammonia positron emission tomography computed tomography(PET-CT).METHODS Congenital CAFs were incidentally detected during coronary angiography(CAG) procedures in 11 adult patients(six males and five females) with a mean age of 64.3 years(range 41-81). Patients were collected from three institutes in the Netherlands. The characteristics of the fistulas(origin, pathway and termination), multiplicity of the origins and pathways of the fistulous vessels were assessed by CAG. Five patients underwent adenosine pharmacologic stress ^(13)N-ammonia PET-CT to assess myocardial perfusion and the functional behavior of the fistula. RESULTS Eleven patients with 12 CAFs, 10 unilateral and one bilateral, originating from the left anterior descending coronary artery(n = 8), right coronary artery(n = 2) and circumflex(n = 2). All fistulas were of the vascular type, terminating into either the pulmonary artery(n = 11) or coronary sinus(n = 1). The CAG delineated the characteristics of the fistula(origin, pathway and termination). Multiplicity of the origins and pathways of the fistulous vessels were common in most fistulas(8/12, 67% and 9/12, 75%, respectively). Multiplicity was common among the different fistula components(23/36, 64%). Adenosine pharmacologic stress ^(13)N-ammonia PET-CT revealed normal myocardial perfusion and ejection fraction in all but one patient, who showed a reduced ejection fraction.CONCLUSION PET-CT may be helpful for assessing the functional status of congenital CAFs in selected patients regarding clinical decision-making. Studies with a larger patient series are warranted.

关 键 词：CORONARY angiography Coronary-pulmonary ARTERY FISTULAS ADENOSINE AMMONIA positron emission tomography computed tomography CORONARY vascular FISTULAS CONGENITAL CORONARY ARTERY FISTULAS 

分 类 号：R[医药卫生]