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CT of Coronary Artery Anomalies

  • Long Jiang Zhang
  • Shahryar M. Chowdhury
  • Guang Ming Lu
Chapter
Part of the Contemporary Medical Imaging book series (CMI)

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.

Keywords

Congenital cardiac anomalies Coronary artery anomalies Computed tomographic angiography 

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References

  1. 1.
    Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296–305.CrossRefGoogle Scholar
  2. 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.Google Scholar
  3. 3.
    Sundaram B, Kreml R, Patel S. Imaging of coronary artery anomalies. Radiol Clin N Am. 2010;48(4):711–27.CrossRefGoogle Scholar
  4. 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.CrossRefGoogle Scholar
  5. 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.CrossRefGoogle Scholar
  6. 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.CrossRefGoogle Scholar
  7. 7.
    Shi H, Aschoff AJ, Brambs HJ, Hoffmann MH. Multislice CT imaging of anomalous coronary arteries. Eur Radiol. 2004;14(12):2172–81.CrossRefGoogle Scholar
  8. 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.CrossRefGoogle Scholar
  9. 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.CrossRefGoogle Scholar
  10. 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.CrossRefGoogle Scholar
  11. 11.
    Schoepf UJ. CT of the heart: principles and applications. In: Contemporary cardiology. Totowa: Humana Press; 2005.Google Scholar
  12. 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.CrossRefGoogle Scholar
  13. 13.
    Greenberg MA, Fish BG, Spindola-Franco H. Congenital anomalies of coronary artery: classification and significance. Radiol Clin North Am. 1989;27:1127–46.PubMedGoogle Scholar
  14. 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.CrossRefGoogle Scholar
  15. 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 333-314CrossRefGoogle Scholar
  16. 16.
    Raimondi F, Bonnet D. Imaging of congenital anomalies of the coronary arteries. Diagn Interv Imaging. 2016;97(5):561–9.CrossRefGoogle Scholar
  17. 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.CrossRefGoogle Scholar
  18. 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.CrossRefGoogle Scholar
  19. 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.CrossRefGoogle Scholar
  20. 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.CrossRefGoogle Scholar
  21. 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.CrossRefGoogle Scholar
  22. 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.CrossRefGoogle Scholar
  23. 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.CrossRefGoogle Scholar
  24. 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.PubMedGoogle Scholar
  25. 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.PubMedPubMedCentralGoogle Scholar
  26. 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.CrossRefGoogle Scholar
  27. 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.CrossRefGoogle Scholar
  28. 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.CrossRefGoogle Scholar
  29. 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.CrossRefGoogle Scholar
  30. 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.CrossRefGoogle Scholar
  31. 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.CrossRefGoogle Scholar
  32. 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.CrossRefGoogle Scholar
  33. 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.CrossRefGoogle Scholar
  34. 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.CrossRefGoogle Scholar
  35. 35.
    Pena E, Nguyen ET, Merchant N, Dennie C. ALCAPA syndrome: not just a pediatric disease. Radiographics. 2009;29(2):553–65.CrossRefGoogle Scholar
  36. 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.CrossRefGoogle Scholar
  37. 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.CrossRefGoogle Scholar
  38. 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.CrossRefGoogle Scholar
  39. 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.CrossRefGoogle Scholar
  40. 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.CrossRefGoogle Scholar
  41. 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.CrossRefGoogle Scholar
  42. 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.CrossRefGoogle Scholar
  43. 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.CrossRefGoogle Scholar
  44. 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.CrossRefGoogle Scholar
  45. 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.CrossRefGoogle Scholar
  46. 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.PubMedGoogle Scholar
  47. 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.CrossRefGoogle Scholar

Copyright information

© Humana Press 2019

Authors and Affiliations

  • Long Jiang Zhang
    • 1
  • Shahryar M. Chowdhury
    • 2
  • Guang Ming Lu
    • 1
  1. 1.Department of Medical ImagingJinling Hospital, Medical School of Nanjing UniversityNanjingChina
  2. 2.Division of Pediatric Cardiology, Department of PediatricsMedical University of South CarolinaCharlestonUSA

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