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Erschienen in: Pediatric Cardiology 3/2014

01.03.2014 | Original Article

Single Coronary Artery Anomaly: Classification and Evaluation Using Multidetector Computed Tomography and Magnetic Resonance Angiography

verfasst von: Soma Mandal, Sameh S. Tadros, Shephaly Soni, Shobhit Madan

Erschienen in: Pediatric Cardiology | Ausgabe 3/2014

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Abstract

The aim of this study was to use multidetector computed tomography (MDCT) and magnetic resonance (MRA) angiography to illustrate the classification and clinical characteristics of single coronary artery anomaly (SCAA). Retrospective evaluation of 22 adult and pediatric patients with SCAA by way of a medical archiving system was performed between June 2001 and August 2012. Imaging modalities used for coronary artery evaluation included MRA and MDCT angiography. Of the 22 patients, the majority (n = 8; 36 %) showed an interarterial course, the subtype having the worst prognosis. The retroaortic course (n = 3; 14 %) and course anterior to the pulmonary trunk (n = 3; 14 %) were the next most frequent patterns. Additional types (n = 8; 36 %) included the following: L-I, R-III, septal, and combined. Four patients (18 %) showed atherosclerotic involvement. SCAA anomaly was diagnosed as an incidental finding in the majority of patients evaluated initially for cardiovascular diseases (n = 19; 86 %). Two patients (9 %) required surgical interventions solely for their anomaly. Nine patients (41 %) were found to have coexisting congenital heart disease. Although conventional catheter angiography is responsible for the current classification of SCAA, advanced imaging modalities are useful in the evaluation of morphological and clinical characteristics of single coronary arteries.
Literatur
1.
Zurück zum Zitat Angelini P (2002) Coronary artery anomalies—current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines. Tex Heart Inst J 29:271–278PubMedCentralPubMed Angelini P (2002) Coronary artery anomalies—current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines. Tex Heart Inst J 29:271–278PubMedCentralPubMed
2.
Zurück zum Zitat Angelini P, Fairchild VD (1999) Coronary artery anomalies: A comprehensive approach. Lippincott Williams & Wilkins, Philadelphia Angelini P, Fairchild VD (1999) Coronary artery anomalies: A comprehensive approach. Lippincott Williams & Wilkins, Philadelphia
3.
Zurück zum Zitat Angelini P, Flamm S (2007) Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults. Catheter Cardiol Interv 69:942–954CrossRef Angelini P, Flamm S (2007) Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults. Catheter Cardiol Interv 69:942–954CrossRef
4.
Zurück zum Zitat Angelini P, Velasco JA, Flamm S (2002) Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 105:2449–2954CrossRefPubMed Angelini P, Velasco JA, Flamm S (2002) Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 105:2449–2954CrossRefPubMed
5.
Zurück zum Zitat Basso C, Maron BJ, Corrado D, Thiene G (2000) Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol 35:1493–1501CrossRefPubMed Basso C, Maron BJ, Corrado D, Thiene G (2000) Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol 35:1493–1501CrossRefPubMed
6.
Zurück zum Zitat Celik T, Kursaklioglu H, Iyisoy A, Bozlar U (2011) Single coronary artery but dual left anterior descending coronary artery anomaly. Cardiovasc Revasc Med 12(1):65–66CrossRefPubMed Celik T, Kursaklioglu H, Iyisoy A, Bozlar U (2011) Single coronary artery but dual left anterior descending coronary artery anomaly. Cardiovasc Revasc Med 12(1):65–66CrossRefPubMed
7.
Zurück zum Zitat Chaitman BR, Lesperance J, Saltiel J, Bourassa MG (1976) Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation 53:122–131CrossRefPubMed Chaitman BR, Lesperance J, Saltiel J, Bourassa MG (1976) Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries. Circulation 53:122–131CrossRefPubMed
8.
Zurück zum Zitat Cheitlin MD, De Castro CM, McAllister HA (1974) Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva: a not-so-minor congenital anomaly. Circulation 50:780–787CrossRefPubMed Cheitlin MD, De Castro CM, McAllister HA (1974) Sudden death as a complication of anomalous left coronary origin from the anterior sinus of Valsalva: a not-so-minor congenital anomaly. Circulation 50:780–787CrossRefPubMed
9.
Zurück zum Zitat Choi HY, Kim JW, Moon JM, Kim YJ, Choi CU, Lim HE et al (2010) Unusual dominant course of left circumflex coronary artery to right coronary artery territory with absent right coronary artery. J Cardiol 55(1):117–119CrossRefPubMed Choi HY, Kim JW, Moon JM, Kim YJ, Choi CU, Lim HE et al (2010) Unusual dominant course of left circumflex coronary artery to right coronary artery territory with absent right coronary artery. J Cardiol 55(1):117–119CrossRefPubMed
10.
Zurück zum Zitat Cohen LS, Shaw LD (1967) Fatal myocardial infarction in an 11-year-old boy associated with a unique coronary artery anomaly. Am J Cardiol 19:420–423CrossRefPubMed Cohen LS, Shaw LD (1967) Fatal myocardial infarction in an 11-year-old boy associated with a unique coronary artery anomaly. Am J Cardiol 19:420–423CrossRefPubMed
11.
Zurück zum Zitat Desmet W, Vanhaecke J, Vrolix M et al (1992) Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J 13:1637–1640PubMed Desmet W, Vanhaecke J, Vrolix M et al (1992) Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J 13:1637–1640PubMed
12.
Zurück zum Zitat DuBose DE, Fisher RS (1956) Single coronary artery: report of two cases. Ann Intern Med 44:1024–1030CrossRef DuBose DE, Fisher RS (1956) Single coronary artery: report of two cases. Ann Intern Med 44:1024–1030CrossRef
13.
Zurück zum Zitat Fantoni JB (1699) Observationes anatomico medicos selectiores. Turin, Italy Fantoni JB (1699) Observationes anatomico medicos selectiores. Turin, Italy
14.
Zurück zum Zitat Halperin IC, Penny JL, Kennedy RJ (1967) Single coronary artery. Antemortem diagnosis in a patient with congestive heart failure. Am J Cardiol 19(3):424–427CrossRefPubMed Halperin IC, Penny JL, Kennedy RJ (1967) Single coronary artery. Antemortem diagnosis in a patient with congestive heart failure. Am J Cardiol 19(3):424–427CrossRefPubMed
15.
Zurück zum Zitat Han BK, Lindberg J, Overman D, Schwartz RS, Grant K, Lesser JR (2012) Safety and accuracy of dual source coronary computed tomography angiography in the pediatric population. J Cardiovasc Comput Tomogr 6(4):252–259CrossRefPubMed Han BK, Lindberg J, Overman D, Schwartz RS, Grant K, Lesser JR (2012) Safety and accuracy of dual source coronary computed tomography angiography in the pediatric population. J Cardiovasc Comput Tomogr 6(4):252–259CrossRefPubMed
16.
Zurück zum Zitat Hurwitz RA, Smith W, King H, Girod DA, Caldwell RL (1980) Tetralogy of Fallot with abnormal coronary artery: 1967 to 1977. J Thorac Cardiovasc Surg 80:129–134PubMed Hurwitz RA, Smith W, King H, Girod DA, Caldwell RL (1980) Tetralogy of Fallot with abnormal coronary artery: 1967 to 1977. J Thorac Cardiovasc Surg 80:129–134PubMed
17.
Zurück zum Zitat Kelley MJ, Wolfson S, Marshall R (1977) Single coronary artery from the right sinus of Valsalva: angiography, anatomy and clinical significance. Am J Roentgenol 128:257–262CrossRef Kelley MJ, Wolfson S, Marshall R (1977) Single coronary artery from the right sinus of Valsalva: angiography, anatomy and clinical significance. Am J Roentgenol 128:257–262CrossRef
18.
Zurück zum Zitat Kimbris D, Iskandrian AS, Segal BL, Bemis CE (1978) Anomalous aortic origin of coronary arteries. Circulation 58:606–615CrossRef Kimbris D, Iskandrian AS, Segal BL, Bemis CE (1978) Anomalous aortic origin of coronary arteries. Circulation 58:606–615CrossRef
19.
Zurück zum Zitat Lipton MJ, Barry WH, Obrez I et al (1979) Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology 130:39–47CrossRefPubMed Lipton MJ, Barry WH, Obrez I et al (1979) Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology 130:39–47CrossRefPubMed
20.
Zurück zum Zitat Longenecker CG, Reemtsma K, Creech O Jr (1961) Surgical implication of a single coronary. A review and two case reports. Am Heart J 61:382–385CrossRefPubMed Longenecker CG, Reemtsma K, Creech O Jr (1961) Surgical implication of a single coronary. A review and two case reports. Am Heart J 61:382–385CrossRefPubMed
21.
Zurück zum Zitat Manninen V, Rissanen VT, Halonen PI (1970) Coronary ostium outside the aortic sinus: a factor in the etiology of this ischemic heart disease. Adv Cardiol 4:94–98CrossRefPubMed Manninen V, Rissanen VT, Halonen PI (1970) Coronary ostium outside the aortic sinus: a factor in the etiology of this ischemic heart disease. Adv Cardiol 4:94–98CrossRefPubMed
22.
Zurück zum Zitat McClelland JT, Joki E (1968) Congenital anomalies of coronary arteries as cause of sudden death associated with physical exertion. Am J Clin Pathol 50:229–233 McClelland JT, Joki E (1968) Congenital anomalies of coronary arteries as cause of sudden death associated with physical exertion. Am J Clin Pathol 50:229–233
23.
Zurück zum Zitat Moscariello A, Takx RA, Schoepf UJ, Renker M, Zwerner PL, O’Brien TX et al (2011) Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique—comparison with traditional filtered back projection. Eur Radiol 21(10):2130–2138CrossRefPubMed Moscariello A, Takx RA, Schoepf UJ, Renker M, Zwerner PL, O’Brien TX et al (2011) Coronary CT angiography: image quality, diagnostic accuracy, and potential for radiation dose reduction using a novel iterative image reconstruction technique—comparison with traditional filtered back projection. Eur Radiol 21(10):2130–2138CrossRefPubMed
24.
25.
Zurück zum Zitat Plachta A, Spear FD (1954) Congenital absence of right coronary artery. Am J Clin Pathol 24:1035–1039PubMed Plachta A, Spear FD (1954) Congenital absence of right coronary artery. Am J Clin Pathol 24:1035–1039PubMed
26.
Zurück zum Zitat Rigatelli GG, Gemelli MM, Zamboni AA, Docali GG, Rossi PP, Rossi DD et al (2004) Are coronary artery anomalies an accelerating factor for coronary atherosclerosis development? Angiology 55(1):29–35CrossRefPubMed Rigatelli GG, Gemelli MM, Zamboni AA, Docali GG, Rossi PP, Rossi DD et al (2004) Are coronary artery anomalies an accelerating factor for coronary atherosclerosis development? Angiology 55(1):29–35CrossRefPubMed
27.
Zurück zum Zitat Rigatelli G, Docali G, Rossi P et al (2005) Validation of a clinical-significance-based classification of coronary artery anomalies. Angiology 56:25–34CrossRefPubMed Rigatelli G, Docali G, Rossi P et al (2005) Validation of a clinical-significance-based classification of coronary artery anomalies. Angiology 56:25–34CrossRefPubMed
28.
Zurück zum Zitat Roberts WC, Shirani J (1992) The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). Am J Cardiol 70:119–121CrossRefPubMed Roberts WC, Shirani J (1992) The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). Am J Cardiol 70:119–121CrossRefPubMed
29.
Zurück zum Zitat Sharbaugh AH, White RS (1974) Single coronary artery: analysis of the anatomic variation, clinical importance, and report of five cases. JAMA 230:243–246CrossRefPubMed Sharbaugh AH, White RS (1974) Single coronary artery: analysis of the anatomic variation, clinical importance, and report of five cases. JAMA 230:243–246CrossRefPubMed
30.
Zurück zum Zitat Shirani J, Roberts WC (1993) Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. J Am Coll Cardiol 21:137–143CrossRefPubMed Shirani J, Roberts WC (1993) Solitary coronary ostium in the aorta in the absence of other major congenital cardiovascular anomalies. J Am Coll Cardiol 21:137–143CrossRefPubMed
31.
Zurück zum Zitat Shukla V, Freedom RM, Black MD (2000) Single coronary artery and complete transposition of the great arteries: a technical challenge resolved? Ann Thorac Surg 69:568–571CrossRefPubMed Shukla V, Freedom RM, Black MD (2000) Single coronary artery and complete transposition of the great arteries: a technical challenge resolved? Ann Thorac Surg 69:568–571CrossRefPubMed
32.
Zurück zum Zitat Smith JC (1950) Review of single coronary artery with report of two cases. Circulation 1:1168–1175CrossRefPubMed Smith JC (1950) Review of single coronary artery with report of two cases. Circulation 1:1168–1175CrossRefPubMed
33.
Zurück zum Zitat Tanawuttiwat T, Harindhanavudhi T, Trivedi D (2009) Anomalous single coronary artery with absent right coronary artery diagnosed with the aid of 64-slice multidetector computed tomographic angiography. Tex Heart Inst J 36(4):362–363PubMedCentralPubMed Tanawuttiwat T, Harindhanavudhi T, Trivedi D (2009) Anomalous single coronary artery with absent right coronary artery diagnosed with the aid of 64-slice multidetector computed tomographic angiography. Tex Heart Inst J 36(4):362–363PubMedCentralPubMed
34.
Zurück zum Zitat Topaz O, Demarchena R, Perin E, Sommer LS, Mallon SM, Chahine RA (1992) Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 34:129–138CrossRefPubMed Topaz O, Demarchena R, Perin E, Sommer LS, Mallon SM, Chahine RA (1992) Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 34:129–138CrossRefPubMed
35.
Zurück zum Zitat Trost B, Fernandez-Friera L, Sanz J (2010) Anomalous origin of the three major coronary arteries from a single common ostium. J Invasive Cardiol 22(10):499–501PubMed Trost B, Fernandez-Friera L, Sanz J (2010) Anomalous origin of the three major coronary arteries from a single common ostium. J Invasive Cardiol 22(10):499–501PubMed
36.
Zurück zum Zitat Virmani R, Burke AP, Farb A (2000) The pathology of sudden cardiac death in athletes. In: Williams RA (ed) The athlete and heart disease. Lippincott Williams & Wilkins, Philadelphia, pp 249–272 Virmani R, Burke AP, Farb A (2000) The pathology of sudden cardiac death in athletes. In: Williams RA (ed) The athlete and heart disease. Lippincott Williams & Wilkins, Philadelphia, pp 249–272
37.
Zurück zum Zitat Wilkins CE, Betancourt B, Mathur VS et al (1988) Coronary artery anomalies: a review of more than 10,000 patients from the Clayton Cardiovascular Laboratories. Texas Heart Inst J 15:166–173 Wilkins CE, Betancourt B, Mathur VS et al (1988) Coronary artery anomalies: a review of more than 10,000 patients from the Clayton Cardiovascular Laboratories. Texas Heart Inst J 15:166–173
38.
Zurück zum Zitat Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 21:28–40CrossRefPubMed Yamanaka O, Hobbs RE (1990) Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 21:28–40CrossRefPubMed
39.
Zurück zum Zitat Yurtdacs M, Gulen O (2012) Anomalous origin of the right coronary artery from the left anterior descending artery: review of the literature. Cardiol J 19(2):122–129CrossRef Yurtdacs M, Gulen O (2012) Anomalous origin of the right coronary artery from the left anterior descending artery: review of the literature. Cardiol J 19(2):122–129CrossRef
Metadaten
Titel
Single Coronary Artery Anomaly: Classification and Evaluation Using Multidetector Computed Tomography and Magnetic Resonance Angiography
verfasst von
Soma Mandal
Sameh S. Tadros
Shephaly Soni
Shobhit Madan
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Pediatric Cardiology / Ausgabe 3/2014
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-013-0798-x

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