Coronary artery anomalies with a shunt: Evaluation with electron-beam CT

Purpose: Our goal was to evaluate the role of electron-beam CT (EBT) in the diagnosis of patients with coronary artery anomalies with a shunt. Method: We performed EBT in seven patients with coronary artery anomalies with a shunt. Four cases were coronary artery fistula (CAF) and three were an anomalous origin of the left coronary artery from the pulmonary artery (ALCA from PA). Serial single volume mode scanning was performed at end-diastole to evaluate the anatomical course of the anomalous coronary arteries. Cine mode scanning was done in all but one to examine the ventricular wall motion and volumetrics. Results: EBT could detect the course and drainage sites of all CAFs and ALCAs from PA. Cine mode scanning revealed reduced wall motion in one case with CAF and two cases with ALCA from PA. Conclusion: EBT serves a useful role in the assessment of coronary artery anomalies with a shunt.