[Cardiac computed tomography in preoperative management of a congenital coronary anomaly].
We report the case of a 81-year-old man presenting with stable exercise angina pectoris. The stress test is positive and the coronaro-angiographic evaluation demonstrates a coronary fistula between the left anterior descending (LAD) artery and the pulmonary artery trunk. The mid LAD presents a significant lesion after the origin of the fistula. A cardiac computed tomography is used before surgical treatment. Coronary artery fistulas are unusual congenital or acquired coronary artery abnormalities in which blood is shunt into a cardiac chamber, great vessel or other structure. Low-pressure structure is the most common site of drainage of the coronary fistula. The clinical presentation of coronary fistulas is mainly dependent on the severity of the left-to-right shunt. Various cardiac imaging modalities are used for diagnosis and anatomical exploration before surgical or percutaneous intervention if the closure of the fistula is indicated.
Davin
L
L
Service de cardiologie, domaine universitaire B. 35, CHU Sart-Tilman, 4000 Liège, Belgique. laurentdavin@Yahoo.fr
Gach
O
O
Martinez
C
C
Bruyère
P-J
PJ
Radermecker
M
M
Grenade
T
T
Piérard
L
L
Legrand
V
V
D000369:Aged, 80 and over; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000601:surgery*; D006801:Humans; D008297:Male; D011300:Preoperative Care; D014057:Tomography, X-Ray Computed