{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:28:50Z","timestamp":1774438130159,"version":"3.50.1"},"reference-count":65,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T00:00:00Z","timestamp":1409875200000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Congenital coronary\u2010pulmonary fistulas (<jats:styled-content style=\"fixed-case\">CPFs<\/jats:styled-content>) are commonly unilateral, but bilateral and multilateral fistulas may occur. In multilateral <jats:styled-content style=\"fixed-case\">CPFs<\/jats:styled-content>, the value of a multidetector computed tomography (<jats:styled-content style=\"fixed-case\">MDCT<\/jats:styled-content>) imaging technique as an adjuvant to coronary angiography (<jats:styled-content style=\"fixed-case\">CAG<\/jats:styled-content>) is eminent. The purpose of this study was to describe the clinical presentation, diagnostic modalities, and management of coincidentally detected congenital <jats:styled-content style=\"fixed-case\">CPFs<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Unilateral and multilateral coronary\u2010pulmonary fistulas are increasingly detected due to the wide speard application of multidetector computed tomography which might be a supplementary or replacing to conventional coronary angiography.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We evaluated 14 adult patients with congenital coronary artery fistulas (CAFs) who were identified from several Dutch cardiology departments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Fourteen adult patients (5 female and 9 male), with a mean age of 57.5 years (range, 24\u201380 years) had the following abnormal findings: audible systolic cardiac murmur (n\u2009=\u20094), chronic atrial fibrillation (n\u2009=\u20092), nonsustained ventricular tachycardia (n\u2009=\u20091), and cardiomegaly on chest x\u2010ray (n\u2009=\u20092). Echocardiography revealed normal findings with trivial valvular abnormalities (n\u2009=\u20099), depressed left ventricle systolic function (n\u2009=\u20093), and severe mitral regurgitation and atrial dilatation (n\u2009=\u20092). The findings in the rest of the patients were unremarkable. <jats:styled-content style=\"fixed-case\">CAG<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">MDCT<\/jats:styled-content> were used as a diagnostic imaging techniques either alone (<jats:styled-content style=\"fixed-case\">CAG<\/jats:styled-content>, n\u2009=\u20096; <jats:styled-content style=\"fixed-case\">MDCT<\/jats:styled-content>, n\u2009=\u20091) or in combination (n\u2009=\u20097). Single modality and multimodality diagnostic methods revealed 22 fistulas including <jats:styled-content style=\"fixed-case\">CPFs<\/jats:styled-content> (n\u2009=\u200915), coronary cameral fistulas terminating into the right (n\u2009=\u20092) and the left atrium (n\u2009=\u20091), and systemic\u2010pulmonary fistulas (n\u2009=\u20094). Of all of the fistulas, 10 were unilateral, 6 were bilateral, and 6 was hexalateral. <jats:styled-content style=\"fixed-case\"><jats:sup>13<\/jats:sup>N<\/jats:styled-content>\u2010ammonia positron emission tomography\u2010computed tomography was performed in 3 patients revealing decreased myocardial perfusion reserve.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">CAG<\/jats:styled-content> remains the gold standard for detection of <jats:styled-content style=\"fixed-case\">CPFs<\/jats:styled-content>. An adjuvant technique using <jats:styled-content style=\"fixed-case\">MDCT<\/jats:styled-content> provides full anatomical details of the fistulas.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22297","type":"journal-article","created":{"date-parts":[[2014,9,5]],"date-time":"2014-09-05T15:27:09Z","timestamp":1409930829000},"page":"536-545","source":"Crossref","is-referenced-by-count":19,"title":["Unilateral and Multilateral Congenital Coronary\u2010Pulmonary Fistulas in Adults: Clinical Presentation, Diagnostic Modalities, and Management With a Brief Review of the Literature"],"prefix":"10.1002","volume":"37","author":[{"given":"Salah A. M.","family":"Said","sequence":"first","affiliation":[{"name":"Department of Cardiology Hospital Group Twente  Hengelo the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rogier L. G.","family":"Nijhuis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hospital Group Twente  Hengelo the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeroen W. op den","family":"Akker","sequence":"additional","affiliation":[{"name":"Department of Radiology Hospital Group Twente  Hengelo the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Takechi","sequence":"additional","affiliation":[{"name":"Department of Embryology Iwate Medical University  Iwate Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riemer H. J. A.","family":"Slart","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging UMC Groningen  Groningen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes S.","family":"Bos","sequence":"additional","affiliation":[{"name":"Department of Cardiology Radboud UMC  Nijmegen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caspar R.","family":"Hoorntje","sequence":"additional","affiliation":[{"name":"Department of Cardiology Orbis Medisch Centrum  Sittard The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. Gert van","family":"Houwelingen","sequence":"additional","affiliation":[{"name":"Department of Cardiology Medisch Spectrum Twente  Enschede the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirjam","family":"Bakker\u2010de Boo","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gelre Apeldoorn  Apeldoorn the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Braam","sequence":"additional","affiliation":[{"name":"Department of Cardiology Gelre Apeldoorn  Apeldoorn the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thijs M. W. J.","family":"Vet","sequence":"additional","affiliation":[{"name":"Department of Cardiology Scheper Ziekenhuis  Emmen the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,5]]},"reference":[{"key":"e_1_2_7_2_1","first-page":"225","article-title":"Uber der ursprung einer akzessorische A coronaria aus der A pulmonalis","volume":"24","author":"Krause W.","year":"1865","journal-title":"Z Rationell Med."},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.11152\/mu.2013.2066.151.ah1lcp2"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2013.04.009"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1010-7940(01)00999-X"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.5543\/tkda.2012.01715"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.74.5.602b"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/heart.87.1.60-a"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003319706292572"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/314685"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-006-9146-z"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8191.2006.00308.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/64015972"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2011.41.4.213"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2006.11.018"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-011-0405-1"},{"key":"e_1_2_7_17_1","first-page":"271","article-title":"Coronary artery anomalies\u2014current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines","volume":"29","author":"Angelini P.","year":"2002","journal-title":"Tex Heart Inst J"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.01.047"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.07.009"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810210110"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(98)00878-9"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-002-1334-6"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90016-0"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.eurheartj.a062086"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.1810350207"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02602964"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.4960200907"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1253\/circj.72.1242"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(00)01593-9"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003319707304880"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001407"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.65.4.810"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(62)90286-7"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.58.1.25"},{"key":"e_1_2_7_35_1","first-page":"463","article-title":"Ueber akessorische, von der arteria pulmonalis abgehende herzgefaesse und ihre bedentung fuer das verstaendnis der formalen genese des ursprunges einer oder beider coronararterien von der lungenschlagader","volume":"66","author":"Hackensellner HA","year":"1955","journal-title":"Frankf Z Path."},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(70)90615-6"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(89)90789-8"},{"key":"e_1_2_7_38_1","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/00005792-199003000-00004","article-title":"Coronary artery fistula: an abnormality affecting all age groups","volume":"69","author":"Sapin P","year":"1990","journal-title":"Medicine (Baltimore)."},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v3.i8.267"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-011-0088-2"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-010-9718-9"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20286"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-007-0217-1"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcr254"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2005.08.027"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcct.2010.05.017"},{"key":"e_1_2_7_47_1","first-page":"327","article-title":"Coronary\u2010to\u2010pulmonary fistulae: what are they? What are their causes? What are their functional consequences?","volume":"27","author":"Angelini P.","year":"2000","journal-title":"Tex Heart Inst J."},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25170"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2012.42.12.845"},{"key":"e_1_2_7_50_1","first-page":"E177","article-title":"Coronary to pulmonary artery fistulas: an incidental finding with challenging therapeutic options","volume":"23","author":"Testuz A","year":"2011","journal-title":"J Invasive Cardiol."},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12928-012-0096-1"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2006.08.117"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/ca.22141"},{"key":"e_1_2_7_54_1","first-page":"203","article-title":"Congenital systemic and coronary\u2010to\u2010pulmonary artery fistulas","volume":"16","author":"Ohkura K","year":"2010","journal-title":"Ann Thorac Cardiovasc Surg."},{"key":"e_1_2_7_55_1","first-page":"486187","article-title":"Coronary anomaly and coronary artery fistula as cause of angina pectoris with literature review","volume":"2011","author":"Koneru J","year":"2011","journal-title":"Case Rep Vasc Med."},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocs.12011"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2013.43.4.281"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(10)80239-6"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31821b1f10"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1747-0803.2006.00012.x"},{"key":"e_1_2_7_61_1","first-page":"1","article-title":"Bilateral coronary artery fistula as a cause of angina pectoris","volume":"2013","author":"Yang SW","year":"2013","journal-title":"BMJ Case Rep."},{"key":"e_1_2_7_62_1","first-page":"132","article-title":"Transcatheter closure of coronary artery fistulas","volume":"56","author":"Trehan V","year":"2004","journal-title":"Indian Heart J."},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24656"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.3892\/etm.2013.1262"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-013-0620-z"},{"key":"e_1_2_7_66_1","first-page":"109","article-title":"Video\u2010thoracoscopy closure of coronary artery fistula: case report","volume":"25","author":"Fortunato Junior JA","year":"2010","journal-title":"Rev Bras Cir Cardiovasc."}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22297","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22297","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T23:08:29Z","timestamp":1696633709000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,9]]},"references-count":65,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1002\/clc.22297"],"URL":"https:\/\/doi.org\/10.1002\/clc.22297","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,9]]}}}