Skip to main content
Hauptrubriken
CME Facharzt-Training Webinare Zeitschriften Bücher e.Medpedia Podcast
Service
Jobbörse Info & Hilfe
Fachgebiete
Anästhesiologie Allgemeinmedizin Arbeitsmedizin Augenheilkunde Chirurgie Dermatologie Gynäkologie und Geburtshilfe HNO Innere Medizin Kardiologie Neurologie Onkologie und Hämatologie Orthopädie und Unfallchirurgie Pädiatrie Pathologie Psychiatrie Radiologie Rechtsmedizin Urologie Zahnmedizin
Themen
Klimawandel und Gesundheit Neues aus dem Markt COVID-19 Praxis und Beruf Seltene Erkrankungen GOÄ & EBM Panorama
Sammlungen
Kasuistiken Algorithmen & Infografiken Blickdiagnosen Arthropedia FlapFinder (für Dermatochirurgen) Videos Kongressberichterstattung Medizin für Apothekerinnen und Apotheker Für Ärztinnen und Ärzte in Weiterbildung Für Medizinstudierende
Erweiterte Suche
Anmelden
nach oben
Current Cardiovascular Imaging Reports
Erschienen in: Current Cardiovascular Imaging Reports 10/2017

01.10.2017 | Cardiac Computed Tomography (T Villines, Section Editor)

Anomalous Coronary Arteries on Computer Tomography Angiography: a Pictorial Review

verfasst von: Jason Nogic, Nitesh Nerlekar, Arthur Nasis

Erschienen in: Current Cardiovascular Imaging Reports | Ausgabe 10/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Coronary artery anomalies (CAA) are a commonly encountered entity on computer tomography angiography (CTA) with observational studies suggesting a prevalence of 1–3%. The purpose of this pictorial review is to succinctly review the recent literature in regards to their individual prevalence, assessment and management strategies when indicated.

Recent Findings

Clinically, the most important anomalies are those with either a malignant course or origin. Recent studies have suggested that anomalous coronary arteries arising from the opposite sinus (ACAOS) are best detected on CTA. In particular, those found in asymptomatic patients over the age of 35, even with high-risk features, do not necessarily mandate revascularisation. We propose a new investigative framework. Additionally, new CTA prevalence data has emerged of individual anomalies which are further discussed.

Summary

Computer tomography angiography has emerged as the gold standard for the assessment of CAAs, and as a result, they are being encountered more frequently in clinical practice. It is important that reporting physicians have a comprehensive knowledge of these anomalies, how they are best described and categorised and particularly recognition of malignant variants that may require intervention.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
1.
Schuetz GM, Zacharopoulou NM, Schlattmann P, Dewey M. Meta-analysis: noninvasive coronary angiography using computed tomography versus magnetic resonance imaging. Ann Intern Med. 2010;152:167–77.CrossRefPubMed
2.
•• von Ballmoos MW, Haring B, Juillerat P, Alkadhi H. Meta-analysis: diagnostic performance of low-radiation-dose coronary computed tomography angiography. Ann Intern Med. 2011;154:413–20. Meta-analysis of 16 studies including 960 patients suggesting that low-dose coronary CTA matches the sensitivity of catheter-based angiography, and is a potential alternative CrossRef
3.
Verdini D, Lee AM, Prabhakar AM, Abbara S, Ghoshhajra B. Detection of cardiac incidental findings on routine chest CT: the impact of dedicated training in cardiac imaging. J Am Coll Radiol. 2016;(30):1–5. S1546-1440(16)00140-X
4.
De Graaf FR, Schuijf JD, van Velzen JE, Kroft LJ, de Roos A, Reiber JHC, et al. Diagnostic accuract of 320-row multidetector computed tomography coronary angiography in non-invasive evaluation of significant coronary artery disease. Eur Heart J. 2010;35:1908–15.CrossRef
5.
Shriki JE, Shinbone JS, Rashid MA, Hindoyan A, Withey JG, DeFrance A, Cunningham M, OliveiraGR, Warren BH, Wilcox A. Identifying, characterizing, and classifying congenital anomalies of the coronary arteries. Radiographics. 2012;32(2):453–68.
6.
Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115:1296–305.PubMed
7.
Angelini P. Normal and anomalous coronary arteries: definitions and classification. Am Heart J. 1989;117:418–34.
8.
Rao A, Pimpalwar Y, Yadu N, Yadav RK. A study of coronary artery variants and anomalies ovserved at a tertiary care armed forces hospital using 64-slice MDCT. Indian Heart J. 2017;69(1):81–6.CrossRefPubMed
9.
Tongut A, Ozyedek Z, Cerezci I, Erenturk S, Hatemi AC. Prevalence of congenital coronary artery anomalies as shown by multi-slibe computer tomography coronary angiography: a single-centre study from Turkey. J Int Med Res. 2016;44(6):1492–505.CrossRefPubMed
10.
Krupinsli M, Urbanczyk-Zawadzka M, Laskowicz B, Irzyk M, Banys R, Klimeczek P, et al. Anomalous origin of the coronary artery from the wrong coronary sinus elevated with computed tomography: “high risk” anatomy and its clinical relevance. Eur Radiol. 2014;24(10):2353–9.CrossRef
11.
Grani C, Benz DC, Schmied C, Vontobel J, Possner M, Clerc OF, et al. Prevalence and characteristics of coronary artery anomalies detected by coronary computer tomography angiography in 5634 consecutive patients in a single centre in Switzerland. Swiss Med Wkly. 2016;146:w14294.PubMed
12.
Namgung J, Kim JA. The prevalence of coronary anomalies in a single centre in Korea: origination, course, and termination anomalies of aberrant coronary arteries detected by ECG-gated cardiac MDCT. BMC Cardiovasc Disord. 2014;14:48.CrossRefPubMedPubMedCentral
13.
Cheng Z, Wang X, Duan Y, Wu L, Wu D, Lian C, et al. Detection of coronary artery anomalies by dual-source CT coronary angiography. Clin Radiol. 2010;65(10):815–22.
14.
Fuchs TA, Stehli J, Bull S, Dougoud S, Clerc OF, Herzog BA, et al. Coronary computed tomography angiography with model-based iterative reconstruction using a radiation exposure similar to chest X-ray examination. Eur Heart J. 2014;35(17):1131–6.CrossRefPubMedPubMedCentral
15.
Halliburton SS, Abbara S, Chen MY, et al. For Society of Cardiovascular Computed Tomography. SCCT guidelines on radiation dose and dose optimization strategies in cardiovascular CT. J Cardiovasc Comput Tomogr. 2011;5:198–224.CrossRefPubMedPubMedCentral
16.
Dewey M, Rief M, Martus P, Kendziora B, Feger S, Dreger H, et al. Evaluation of computer tomography in patients with atypical angina or chest pain clinically referred for invasive coronary angiography: randomised controlled trial. BMJ. 2016;355:i5441.CrossRefPubMedPubMedCentral
17.
Raval A, Jadhav N, Prajapati J, Rawal J, Garg R, Shah K, et al. Distribution of coronary artery anomalies and their evaluation with different imaging modalities. Int J Med Res Rev. 2016;10:1807–19.
18.
Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (writing committee to develop guidelines on the Management of Adults with Congenital Heart Disease): developed in collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:e143–263.CrossRefPubMed
19.
Montalescot G, Sechtem U, Achenbach S, Andreotti F, Arden C, Budaj A, et al. 2013 ESC guidelines on the management of stable coronary artery disease the task force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34(38):2949–3003.CrossRefPubMed
20.
McLarry J, Maros F, Shapiro MD. Coronary artery anomalies: a pictorial review. Curr Cardiovasc Imaging Rep. 2015;8:23.CrossRef
21.
Nasis A, Machado C, Cameron JD, Troupis JM, Meredith IT, Seneviratne SK. Anatomic characteristics and outcome of adults with coronary arteries arising from an anomalous location detected with coronary computed tomography angiography. Int J Cardiovasc Imaging. 2015;31(1):181–91.CrossRefPubMed
22.
•• Cheezum MK, Libertson RR, Shah NR, Villines TC, O’Gara PT, Landzberg MJ. Blankstein. Anomalous aortic origin of a coronary artery from the inappropriate sinus of valsalva. JACC. 2017;69:1592–608. Excellent comprehensive state of the art review discussing ACAOS CrossRefPubMed
23.
Desmet W, Vanhaecke J, Vrolix M, et al. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J. 1992;13:1637–40.CrossRefPubMed
24.
Mandal S, Sameh ST, Shephaly S, Shobhit M. Single coronary artery anomaly: classification and evaluation using multidetector computed tomography and magnetic resonance angiography. Pediatr Cardiol. 2014;35:441–9.CrossRefPubMed
25.
•• Lipton MJ, Barry WH, ORbez I, et al. Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology. 1979;130:39–47. Sentinel paper and description of classification criteria of single coronary artery CrossRefPubMed
26.
Angelini P, Fairchild VD. Coronary artery anomalies: a comprehensive approach. Philadelphia: Lippincott Williams & Wilkins; 1999.
27.
Smith JC. Review of single coronary artery with report of 2 cases. Circulation. 1950;1(5):1168–75.CrossRefPubMed
28.
Sharabaugh AH, White RS. Single coronary artery/ analysis of the anatomic variation, clinical importance, and report of five cases. JAMA. 1974;230:243–6.CrossRef
29.
Aldana-Sepulveda N, Restrepo S, Kimura-Hayama E. Single coronary artery: Spectrum of imaging and findings with multi-detector CT. J Cardiovasc Comput Tomogr. 2013;7:391–9.CrossRefPubMed
30.
Pan C, Azhati G, Xing Y, Wang Y, Liu W. Comparison of congenital artery anomalies between Uyghur and Han: a multi-slice computed tomography study in Xinjiang, China. Chin Med J. 2015;128:15–9.CrossRefPubMedPubMedCentral
31.
Graidis C, Dinitriadis D, Karasavvidis V, Dimitriadis G, Argyropoulou E, Economou F, et al. Prevalence and characteristics of coronary artery anomalies in an adult population undergoing multi-detector-row computed tomography for the evaluation of coronary artery disease. BMC Cardiovasc Disord. 2015;15:112.CrossRefPubMedPubMedCentral
32.
Basso C, Maron BJ, Corrado D, Thiene G. Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden cardiac death in competitive athletes. J Am Coll Cardiol. 2000;35:1493–501.CrossRefPubMed
33.
Ripley DP, Saha A, Teis A, Uddin A, Bijsterveld P, Kidambi A, et al. The distribution and prognosis of anomalous coronary arteries identified by cardiovascular magnetic resonance: 15 year experience from two tertiary centres. J Cardiovasc Magn Reson. 2014;16:34.CrossRefPubMedPubMedCentral
34.
Cheezum MK, Ghoshhajra B, Bittencourt MS, Hulten EA, Bhatt A, Mousavi N, et al. 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;18:224–35.CrossRefPubMed
35.
Opolski MP, Pregowski J, Kruk M, Witkowski A, Kwiecinska S, Lubienska E, et al. Prevalence and characteristics of coronary anomalies originating from the opposite sinus of valsalve in 8522 patients referred for coronary computed tomography angiography. Am J Cardiol. 2013;9:1361–7.CrossRef
36.
Ghadri JR, Kazakauskaite E, Braunschweig S, Burger IA, Frank M, Fiechter M, et al. Congenital coronary anomalies detected by coronary computed tomography compared to invasive coronary angiography. BMC Cardiovasc Disord. 2014;14:81.CrossRefPubMedPubMedCentral
37.
Heermann P, Heindel W, Shulke C. Coronary artery anomalies: diagnosis and classification based on cardiac CT and MRI (CMR) - from ALCAPA to anomalies of termination. Rofo. 2017;1:29–38.
38.
Shuaib W, Arepalli C, Vijayasarathi A, Gunn ML, Nicolau S, Mehta AS, Johnson JO, Khosa F. Coronary anomalies encountered in the acute setting: an imaging review Emerg Radiol. 2014;21(6):631–41.
39.
Lorenz EC, Mookadam F, Mookadam M, Moustafa S, Zehr KJ. A systematic review of anomalous coronary anatomy and an examination of the association with sudden death. Rev Cardiovasc Med. 2006;7:205–13.PubMed
40.
Sintek MA, Singh J, Billadello JJ. Dynamic evaluation of coronary anomalies originating from the opposite sinus of valsalva (ACAOS). Curr Treat Options Cardiovasc Med. 2015;17:47.CrossRefPubMed
41.
• Van Hare GF, Ackermann MJ, Evangelista JA, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task Fforce 4: congenital heart disease: a scientific statement form the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015;66:2372–84. Most recent guideline recommendations for athletes with CAA CrossRefPubMed
42.
• Grani C, Benz DC, Steffen DA, Clerc OF, Schmied C, Possner M, et al. Outcome in middle-aged individuals with anomalous origin of the coronary artery from the opposite sinus: a matched cohort study. Eur Heart J. 2017;0:1–8. Albeit a small case-control study of 68 patients, showed that new incidental diagnosis of middle-aged individuals with ACAOS did not have a statistically different outcome to matched controls with no coronary artery anomalies regardless of whether there was IAC or not
43.
Furbatto F, Esposito G, Raffaele P. Coronary angioplasty and stenting for acute coronary syndrome in patients with isolated single coronary artery: a report of two cases. J Cardiovasc Med. 2009;10(7):550–3.CrossRef
44.
Clark RA, Marler AT, Lin CK, McDonough RJ, Prentice RL, Malik JA, et al. A review of anomalous origination of coronary artery from an opposite sinue of Valsalva (ACAOS) impact on major adverse cardiovascular events based on coronary computerized tomography angiography: a 6-year single centre review. Ther Adv Cardiovasc Dis. 2014;8:237–41.CrossRefPubMed
45.
Adebo D, Jacobson Z, Harris MA. Anomalous origin of the right coronary artery from the posterior, non-coronary sinus of Valsalva diagnosed by cardiac magnetic resonance imaging. Cardiol Young. 2015;25:1006–8.CrossRefPubMed
46.
Eren B, Turkmen N, Senel B. Ectopic high origin of a coronary artery from the aorta – a possible cause of sudden cardiac death. Acta Med Austriaca. 2009;52(4):171–2.
47.
Williams IA, Gersony WNm Hellengrand WE. Anomalous right coronary artery arising from the pulmonary artery: a report of 7 cases and a review of the literature. Am Heart J. 2006;152:1004 e1009–17 e1009.CrossRef
48.
Gibernau JMA, Recalde AA, Marques RB. ARCAPA syndrome in adulthood. Rev Esp Cardiol. 2017;20:S1885–5857.
49.
50.
Al-Dairy A, Rezaei Y, Pouraliakbar H, Mahdavi M, Bayati P, Gholampour-Dehaki M. Surgical repair for anomalous origin of the right coronary artery from the pulmonary artery. Korean Circ J. 2017;47(1):144–7.CrossRefPubMed
51.
Pena E, Nguyen ET, Merchant N, Dennie C. ALCAPA syndrome: not just a pediatric disease. Radiographics. 2009;29(2):553–65.CrossRefPubMed
52.
Yew KL, Kang Z, Anum A. Late presentation of ALCAPA syndrome in an elderly Asian lady. Med J Malaysia. 2016;71(4):217–9.PubMed
53.
Lange R, Vogt M, Horer J, Cleuziou J, Menzel A, Holper K, et al. Long-term results of repair of anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg. 2007;83(4):1463–71.CrossRefPubMed
54.
Spindola-Franco H, Grose R, Solomon N. Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications. Am Heart J. 1983;105:445–55.CrossRefPubMed
55.
•• 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;21:34–41. Comprehensive review and original data of dual LAD variations describing 9 types CrossRefPubMed
56.
Agarwal PP, Kazerooni EA. Dual left anterior descending coronary artery: CT findings. AJR. 2008;191(6):1698–701.CrossRefPubMed
57.
Vohra A, Narula H. Dual left anterior descending artery with anomalous origin of long LAD from pulmonary artery – rare coronary anomaly detected on computed tomography coronary angiography. Indian J Radiol Imagin. 2016;26(2):201–5.CrossRef
58.
Alegria JR, Herrmann J, Holmes JDR, et al. Myocardial bridging. Eur Heart J. 2005;26:1159–68.CrossRefPubMed
59.
Liu G, Qu Y, Chen X, Liao M, Hu H, Cao Y, et al. Measurements of myocardial bridges on computed tomography predict presence of clinical symptoms and outcomes of adverse heart events: a retrospective study in a large population from China. Acta Radiol. 2017;58(9):1068–1076; 284185116682380
60.
Ma E, Ma G, Yu H, Wu W, Li K. Assessment of myocardial bridge and mural coronary artery using gated 256-slice CT angiography: a retrospective study. Sci World J. 2013:1–6; 947876
61.
Nakaura T, Nagayoshi Y, Awai K, Utsunomiya D, Kawano H, Ogawa H, et al. Myocardial bridging is associated with coronary atherosclerosis in the segment proximal to the site of bridging. J Cardiol. 2014;63(2):134–9.CrossRefPubMed
62.
•• Corban MT, Hung OY, Eshtehardi P, Rasoul-Arzrumly E, McDaniel M, Mekonnen G, et al. Myocardial bridging: contemporary understanding of pathophysiology with implications for diagnostic and therapeutic strategies. JACC. 2014;63(22):2346–55. A comprehensive review of the pathophysiology, diagnostic modalities and therapeutic options for myocardial bridging CrossRefPubMedPubMedCentral
63.
Masoomi R, Shah Z, Surineni K, Rosamond T. The prevalence and anatomical patterns of intracavitary coronary arteries: detection by coronary computed tomographic angiography. JACC. 2016;65(10S):A1128.
64.
Lim JJ, Jung JI, Lee BY, et al. Prevalence and types of coronary artery fistulas detected with CT angiography. Am J Roentgenol. 2014;203(3):W237–43.CrossRef
65.
Dashottar S, Singh RK, Malani SK, Sarin A, Arora HS. Role of 256-slice MDCT in the evaluation of coronary artery fistula: a case series with review of the literature. Med J Armed Forces India. 2016;72(4):393–9.CrossRefPubMed
66.
Loukas M, Germain AS, Gabriel A, John A, Rubbs RS, Spicer D. Coronary artery fistula: a review. Cardiovasc Pathol. 2015;24(3):141–8.CrossRefPubMed
67.
Zhang W, Hu R, Zhang L, Zhu H, Zhang H. Outcomes of surgical repair of pediatric coronary artery fistulas. J Thorac Cardiovasc Surg. 2016;152(4):1123–30.CrossRefPubMed
68.
Abreu G, Nabais S, Enes V, Marques J, Costa J, Correia A. Coronary arcade: a rare anomaly of coronary circulation. Rev Port Cardiol. 2014;33(4):241.e1–5.
69.
Gur M, Yilmaz R, Demirbag R. Unidirectional communication between the circumflex and right coronary arteries: a very rare coronary anomaly and cause for ischaemia. Int J Cardiovasc Imaging. 2006;22:339–42.CrossRefPubMed
70.
Montaudon M, Latrabe V, Iriart X, et al. Congenital coronary arteries anomalies: review of the literature and multidetector computer tomorgraphy (MDCT) appearance. Surg Radiol Anat. 2007;29:343–55.CrossRefPubMed
71.
Morrad B, Yazici HU, Aydar Y, Ovali V, Nadir A. Role of gender in types and frequency of coronary artery aneurysm and ectasia. Medicine (Baltimore). 2016;95(31):e4395.CrossRef
72.
Forte E, Aiello M, Inglese M, Infante T, Soricelli A, Tedeschi C, et al. Coronary artery aneurysms detected on computed tomography coronary angiography. Eur Heart J Cardiovasc Imaging. 2016;
73.
Swaye PS, Fisher LD, Litwin P, et al. Aneurysmal coronary artery disease. Circulation. 1983;67:134–8.CrossRefPubMed
Metadaten
Titel
Anomalous Coronary Arteries on Computer Tomography Angiography: a Pictorial Review
verfasst von
Jason Nogic
Nitesh Nerlekar
Arthur Nasis
Publikationsdatum
01.10.2017
Verlag
Springer US
Erschienen in
Current Cardiovascular Imaging Reports / Ausgabe 10/2017
Print ISSN: 1941-9066
Elektronische ISSN: 1941-9074
DOI
https://doi.org/10.1007/s12410-017-9430-4

Neu im Fachgebiet Kardiologie

16.04.2024 | Chronische Herzinsuffizienz | Nachrichten

Sind Betablocker auch für ältere herzschwache Personen nützlich?

16.04.2024 | Stillen, Säuglingsnahrung, Beikost | Nachrichten

Stillende Frauen haben geringeres kardiovaskuläres Risiko

15.04.2024 | ACC 2024 | Kongressbericht | Nachrichten

Selbstexpandierende TAVI-Klappen bei kleinem Aortenanulus im Vorteil

15.04.2024 | ACC 2024 | Kongressbericht | Nachrichten

Verbesserung der HDL-Funktion als Lipidtherapie floppt in Mega-Studie
weitere anzeigen

Update Kardiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen