CTICasesSystemic-to-pulmonary arterial fistula
Imaging findings
CT and selective catheter angiography show massive dilation of the right internal mammary, intercostal, and phrenic arteries, which form a giant network of collaterals that shunt directly into the right lower lobe pulmonary arteries, resulting in high-output cardiac dilation.
Key takeaways
A systemic-to-pulmonary arterial fistula is a rare vascular anomaly where systemic arteries communicate directly with pulmonary arteries (left-to-right shunt). It can be congenital or acquired from chronic pleural inflammation, causing high-output heart failure.
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