The Clinical Value of Dual-source CT in the Diagnosis of Coronary Artery Fistula before and after Surgery

［Abstract］Objective The aim of this study was to explore the clinical value of dual-source CT （DSCT） in the diagnosis of coronary artery fistula （CAF） before and after surgery. Methods A retrospective analysis was performed in 15 cases of patients with CAF， 11 cases of which was treated by surgery during extracorporeal circulation. Results CAF arose from right coronary artery in 8 cases and left coronary artery in 7 cases， with the latter including 3 cases of ramus nodi sinuatrialis fistula， 2 cases of anterior descending branch fistula， and 2 cases of left circumflex fistula. CAF entered into right atrium （6 cases）， right ventricle （5 cases）， left ventricle （4 cases） and left atrium （1 case）. There were dilatation of coronary artery in 8 cases， localized aneurysm in 4 cases， normal coronary artery in 3 cases， single fistula orifice in 11 cases， and multiple fistula orifice in 4 cases. 11 patients underwent surgery under cardiopulmonary bypass （CPB）.The postoperative imaging revealed fistula has been sutured in 10 patients with no residual fistula， including fistula vascular ligation in 3 cases， the proximal imaging and distal occlusion in right coronary artery angioplasty in 1 case， and pseudo diverticulum in 2 cases. Conclusion DSCT examination has significant value in preoperative diagnosis and postoperative follow-up for CAF.