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CT of Coronary Artery Anomalies

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CT of the Heart

Part of the book series: Contemporary Medical Imaging ((CMI))

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Abstract

In conclusion, coronary artery anomalies include anomalies of origin, course, and termination. These anomalies can clearly and accurately be visualized by state-of-the-art MDCT coronary angiography owing to high spatial resolution and three-dimensional imaging capability. It is important to identify and report those anomalies that are malignant, such as interarterial or intramural course in patients with an anomalous coronary origin. Due to its superior ability to depict coronary artery anomalies than conventional invasive coronary angiography, MDCT coronary angiography is the first-line choice for imaging coronary artery anomalies.

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References

  1. Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296–305.

    Article  Google Scholar 

  2. Perez-Pomares JM, de la Pompa JL, Franco D, Henderson D, Ho SY, Houyel L, Kelly RG, Sedmera D, Sheppard M, Sperling S, Thiene G, van den Hoff M, Basso C. Congenital coronary artery anomalies: a bridge from embryology to anatomy and pathophysiology--a position statement of the development, anatomy, and pathology ESC Working Group. Cardiovasc Res. 2016;109(2):204–16.

    Article  Google Scholar 

  3. Sundaram B, Kreml R, Patel S. Imaging of coronary artery anomalies. Radiol Clin N Am. 2010;48(4):711–27.

    Article  Google Scholar 

  4. Angelini P. Novel imaging of coronary artery anomalies to assess their prevalence, the causes of clinical symptoms, and the risk of sudden cardiac death. Circ Cardiovasc Imaging. 2014;7(4):747–54.

    Article  Google Scholar 

  5. van Ooijen PM, Dorgelo J, Zijlstra F, Oudkerk M. Detection, visualization and evaluation of anomalous coronary anatomy on 16-slice multidetector-row CT. Eur Radiol. 2004;14(12):2163–71.

    Article  Google Scholar 

  6. Datta J, White CS, Gilkeson RC, Meyer CA, Kansal S, Jani ML, Arildsen RC, Read K. Anomalous coronary arteries in adults: depiction at multi-detector row CT angiography. Radiology. 2005;235(3):812–8.

    Article  Google Scholar 

  7. Shi H, Aschoff AJ, Brambs HJ, Hoffmann MH. Multislice CT imaging of anomalous coronary arteries. Eur Radiol. 2004;14(12):2172–81.

    Article  Google Scholar 

  8. Young PM, Gerber TC, Williamson EE, Julsrud PR, Herfkens RJ. Cardiac imaging: Part 2, normal, variant, and anomalous configurations of the coronary vasculature. AJR Am J Roentgenol. 2011;197(4):816–26.

    Article  Google Scholar 

  9. Dodd JD, Ferencik M, Liberthson RR, Cury RC, Hoffmann U, Brady TJ, Abbara S. Congenital anomalies of coronary artery origin in adults: 64-MDCT appearance. AJR Am J Roentgenol. 2007;188(2):W138–46.

    Article  Google Scholar 

  10. Shriki JE, Shinbane JS, Rashid MA, Hindoyan A, Withey JG, DeFrance A, Cunningham M, Oliveira GR, Warren BH, Wilcox A. Identifying, characterizing, and classifying congenital anomalies of the coronary arteries. Radiographics. 2012;32(2):453–68.

    Article  Google Scholar 

  11. Schoepf UJ. CT of the heart: principles and applications. In: Contemporary cardiology. Totowa: Humana Press; 2005.

    Google Scholar 

  12. Zhang LJ, Wang YZ, Huang W, Chen P, Zhou CS, Lu GM. Anatomical investigation of the sinus node artery using dual-source computed tomography. Circ J. 2008;72(10):1615–20.

    Article  Google Scholar 

  13. Greenberg MA, Fish BG, Spindola-Franco H. Congenital anomalies of coronary artery: classification and significance. Radiol Clin North Am. 1989;27:1127–46.

    CAS  PubMed  Google Scholar 

  14. Kang JW, Seo JB, Chae EJ, Jang YM, Do KH, Lee JS, Song JW, Lim TH. Coronary artery anomalies: classification and electrocardiogram-gated multidetector computed tomographic findings. Semin Ultrasound CT MR. 2008;29(3):182–94.

    Article  Google Scholar 

  15. Kim SY, Seo JB, Do KH, Heo JN, Lee JS, Song JW, Choe YH, Kim TH, Yong HS, Choi SI, Song KS, Lim TH. Coronary artery anomalies: classification and ECG-gated multi-detector row CT findings with angiographic correlation. Radiographics. 2006;26(2):317–33. discussion 333-314

    Article  Google Scholar 

  16. Raimondi F, Bonnet D. Imaging of congenital anomalies of the coronary arteries. Diagn Interv Imaging. 2016;97(5):561–9.

    Article  CAS  Google Scholar 

  17. Danias PG, Stuber M, McConnell MV, Manning WJ. The diagnosis of congenital coronary anomalies with magnetic resonance imaging. Coron Artery Dis. 2001;12(8):621–6.

    Article  CAS  Google Scholar 

  18. Aldana-Sepulveda N, Restrepo CS, Kimura-Hayama E. Single coronary artery: spectrum of imaging findings with multidetector CT. J Cardiovasc Comput Tomogr. 2013;7(6):391–9.

    Article  Google Scholar 

  19. Desmet W, Vanhaecke J, Vrolix M, Van de Werf F, Piessens J, Willems J, de Geest H. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J. 1992;13(12):1637–40.

    Article  CAS  Google Scholar 

  20. Frescura C, Basso C, Thiene G, Corrado D, Pennelli T, Angelini A, Daliento L. Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol. 1998;29(7):689–95.

    Article  CAS  Google Scholar 

  21. Bunce NH, Lorenz CH, Keegan J, Lesser J, Reyes EM, Firmin DN, Pennell DJ. Coronary artery anomalies: assessment with free-breathing three-dimensional coronary MR angiography. Radiology. 2003;227(1):201–8.

    Article  Google Scholar 

  22. Lim JC, Beale A, Ramcharitar S, Medscape. Anomalous origination of a coronary artery from the opposite sinus. Nat Rev Cardiol. 2011;8(12):706–19.

    Article  Google Scholar 

  23. Barth CW 3rd, Roberts WC. Left main coronary artery originating from the right sinus of Valsalva and coursing between the aorta and pulmonary trunk. J Am Coll Cardiol. 1986;7(2):366–73.

    Article  Google Scholar 

  24. Lorenz EC, Mookadam F, Mookadam M, Moustafa S, Zehr KJ. A systematic overview of anomalous coronary anatomy and an examination of the association with sudden cardiac death. Rev Cardiovasc Med. 2006;7(4):205–13.

    PubMed  Google Scholar 

  25. Angelini P, Walmsley RP, Libreros A, Ott DA. Symptomatic anomalous origination of the left coronary artery from the opposite sinus of valsalva. Clinical presentations, diagnosis, and surgical repair. Tex Heart Inst J. 2006;33(2):171–9.

    PubMed  PubMed Central  Google Scholar 

  26. Ashrafpoor G, Danchin N, Houyel L, Ramadan R, Belli E, Paul JF. Anatomical criteria of malignancy by computed tomography angiography in patients with anomalous coronary arteries with an interarterial course. Eur Radiol. 2015;25(3):760–6.

    Article  Google Scholar 

  27. Krupinski M, Urbanczyk-Zawadzka M, Laskowicz B, Irzyk M, Banys R, Klimeczek P, Gruszczynska K, Baron J. Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: “high-risk” anatomy and its clinical relevance. Eur Radiol. 2014;24(10):2353–9.

    Article  Google Scholar 

  28. Zhang LJ, Wu SY, Huang W, Zhou CS, Lu GM. Anomalous origin of the right coronary artery originating from the left coronary sinus of valsalva with an interarterial course: diagnosis and dynamic evaluation using dual-source computed tomography. J Comput Assist Tomogr. 2009;33(3):348–53.

    Article  Google Scholar 

  29. Zhang LJ, Yang GF, Huang W, Zhou CS, Chen P, Lu GM. Incidence of anomalous origin of coronary artery in 1879 Chinese adults on dual-source CT angiography. Neth Hear J. 2010;18(10):466–70.

    Article  CAS  Google Scholar 

  30. Cheezum MK, Ghoshhajra B, Bittencourt MS, Hulten EA, Bhatt A, Mousavi N, Shah NR, Valente AM, Rybicki FJ, Steigner M, Hainer J, MacGillivray T, Hoffmann U, Abbara S, Di Carli MF, DeFaria Yeh D, Landzberg M, Liberthson R, Blankstein R. Anomalous origin of the coronary artery arising from the opposite sinus: prevalence and outcomes in patients undergoing coronary CTA. Eur Heart J Cardiovasc Imaging. 2017;18(2):224–35.

    Article  Google Scholar 

  31. Lee HJ, Hong YJ, Kim HY, Lee J, Hur J, Choi BW, Chang HJ, Nam JE, Choe KO, Kim YJ. Anomalous origin of the right coronary artery from the left coronary sinus with an interarterial course: subtypes and clinical importance. Radiology. 2012;262(1):101–8.

    Article  Google Scholar 

  32. Chaitman BR, Lesperance J, Saltiel J, Bourassa MG. Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation. 1976;53(1):122–31.

    Article  CAS  Google Scholar 

  33. Gulati R, Reddy VM, Culbertson C, Helton G, Suleman S, Reinhartz O, Silverman N, Hanley FL. Surgical management of coronary artery arising from the wrong coronary sinus, using standard and novel approaches. J Thorac Cardiovasc Surg. 2007;134(5):1171–8.

    Article  Google Scholar 

  34. Schwartz ML, Jonas RA, Colan SD. Anomalous origin of left coronary artery from pulmonary artery: recovery of left ventricular function after dual coronary repair. J Am Coll Cardiol. 1997;30(2):547–53.

    Article  CAS  Google Scholar 

  35. Pena E, Nguyen ET, Merchant N, Dennie C. ALCAPA syndrome: not just a pediatric disease. Radiographics. 2009;29(2):553–65.

    Article  Google Scholar 

  36. Hazirolan T, Canyigit M, Karcaaltincaba M, Dagoglu MG, Akata D, Aytemir K, Besim A. Myocardial bridging on MDCT. AJR Am J Roentgenol. 2007;188(4):1074–80.

    Article  Google Scholar 

  37. Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, Timmins LH, Lutz J, Guyton RA, Samady H. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. J Am Coll Cardiol. 2014;63(22):2346–55.

    Article  Google Scholar 

  38. Konen E, Goitein O, Sternik L, Eshet Y, Shemesh J, Di Segni E. The prevalence and anatomical patterns of intramuscular coronary arteries: a coronary computed tomography angiographic study. J Am Coll Cardiol. 2007;49(5):587–93.

    Article  Google Scholar 

  39. Morales AR, Romanelli R, Tate LG, Boucek RJ, de Marchena E. Intramural left anterior descending coronary artery: significance of the depth of the muscular tunnel. Hum Pathol. 1993;24(7):693–701.

    Article  CAS  Google Scholar 

  40. Ferreira AG Jr, Trotter SE, Konig B Jr, Decourt LV, Fox K, Olsen EG. Myocardial bridges: morphological and functional aspects. Br Heart J. 1991;66(5):364–7.

    Article  Google Scholar 

  41. Lu GM, Zhang LJ, Guo H, Huang W, Merges RD. Comparison of myocardial bridging by dual-source CT with conventional coronary angiography. Circ J. 2008;72(7):1079–85.

    Article  Google Scholar 

  42. Bozlar U, Ugurel MS, Sari S, Akgun V, Ors F, Tasar M. Prevalence of dual left anterior descending artery variations in CT angiography. Diagn Interv Radiol. 2015;21(1):34–41.

    Article  Google Scholar 

  43. Saboo SS, Juan YH, Khandelwal A, George E, Steigner ML, Landzberg M, Rybicki FJ. MDCT of congenital coronary artery fistulas. AJR Am J Roentgenol. 2014;203(3):W244–52.

    Article  Google Scholar 

  44. Said SA, el Gamal MI, van der Werf T. Coronary arteriovenous fistulas: collective review and management of six new cases--changing etiology, presentation, and treatment strategy. Clin Cardiol. 1997;20(9):748–52.

    Article  CAS  Google Scholar 

  45. Zhang LJ, Zhou CS, Wang Y, Jin Z, Yu W, Zhang Z, Zhang B, Fang X, Cui X, Li K, Huang W, Zheng L, Ji XM, Hoffman C, Schoepf UJ, Lu GM. Prevalence and types of coronary to pulmonary artery fistula in a Chinese population at dual-source CT coronary angiography. Acta Radiol. 2014;55(9):1031–9.

    Article  Google Scholar 

  46. Zhou CS, Zhang LJ, Wang YN, Yu W, Huang W, Zhang B, Zhao YE, Chen X, Zheng L, Zhang ZQ, Jin ZY, Lu GM. Incidence and classification diagnosis of coronary artery fistula at dual-source CT coronary angiography. Zhonghua Yi Xue Za Zhi. 2012;92(47):3336–40.

    PubMed  Google Scholar 

  47. Lim JJ, Jung JI, Lee BY, Lee HG. Prevalence and types of coronary artery fistulas detected with coronary CT angiography. AJR Am J Roentgenol. 2014;203(3):W237–43.

    Article  Google Scholar 

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Zhang, L.J., Chowdhury, S.M., Lu, G.M. (2019). CT of Coronary Artery Anomalies. In: Schoepf, U. (eds) CT of the Heart. Contemporary Medical Imaging. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-237-7_45

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  • DOI: https://doi.org/10.1007/978-1-60327-237-7_45

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  • Publisher Name: Humana, Totowa, NJ

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