Coronary artery fistulas in children
- PDF / 601,204 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 8 Downloads / 200 Views
1 · L. Wu2 · F. Liu2 · Q. Shen1 · M. Pa1 · G. Huang2 1 Radiology Department, Children’s Hospital of Fudan University Shanghai, Shanghai 2 Heart Centre, Children’s Hospital of Fudan University, Shanghai
Coronary artery fistulas in children Evaluation with 64-slice multidetector CT
A congenital coronary artery fistula (CAF) consists of an abnormal connection between a coronary artery and a cardiac chamber, great artery, or proximal vena cava [1]. Making an early diagnosis is important for the proper management and prevention of late symptoms and complications. A significantly enlarged coronary artery can usually be detected by transthoracic echocardiography. However, identification of CAFs is limited if a vessel is curvilinear along the epicardium, which impairs the view of the distal segments unless dilated; collateral vessels are small and not well visualized [2]. Coronary angiography remains the gold standard for imaging the coronary arteries [3], but the relationship of CAFs to other structures, their origin, and their course may not be apparent. With coronary angiography it is difficult to measure abnormal tortuous blood vessels in one section. Recently, with the development of multidetector computed tomography (MDCT), the benefits of the greater number of detector rows and submillimeter image thicknesses were found to be suitable for pediatric patients with coronary artery anomalies [4]. In this article, we evaluate the efficacy of 64-slice MDCT in the comprehensive visualization and assessment of the anatomical course of CAF in 10 children.
Patients and methods Population From March 2007 to January 2012, we retrospectively enrolled 10 patients with CAF (4 boys and 6 girls; mean age, 2.9 years;
range, 1–6 years) that had been confirmed by intervention or surgery at our hospital. All 10 patients underwent an echocardiography examination, and all of them were further examined with 64-MDCT angiography for a better depiction of the distal draining vessel site and size. The hospital institutional review board approved the study. Of the patients, 7 had a continuous murmur and 3 had systolic murmur in the absence of valvular or other structural heart disease. The patients’ characteristics, presenting symptoms, and electrocardiography findings are listed in . Tab. 1.
Equipment TTE equipment and scanning protocol
A Philips iE33 ultrasound machine (Philips Medical System, Andover, MA, USA) was outfitted with a transducer frequency ranging from 4 to 12 MHz. The conventional scanning protocol included a two-dimensional mode, color Doppler, pulsed-wave Doppler, and continuouswave Doppler.
MDCT scan protocol
All patients underwent coronary artery imaging with MDCT (Lightspeed VCT; GE Healthcare, Waukesha, WI, USA) without or with breath holding. For the 6 patients who would not cooperate, 10% of chloral hydrate was applied at a dose of 0.5 ml/kg 30 min before scanning. A retrospective electrocardiogram-gated CT scan was performed when the patient
was breathing regularly. We did not use β-blocker therapy to decrease th
Data Loading...
