Imaging Approaches for Coronary Artery Anomalies: Purpose and Techniques

Overview

Journal Curr Cardiol Rep

Publisher Current Science

Specialty Cardiology & Vascular Diseases

Date 2019 Jul 31

PMID 31359160

Citations 8

Authors

Paolo Angelini

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: Comprehensive discussion of alternative techniques in imaging coronary artery anomalies (CAAs) in different diagnostic scenarios.

Recent Findings: At primary screening, intramural course essentially correlates with stenosis and clinical repercussion in some types of CAAs. Potential clinical aims in imaging patients with CAAs may be primary screening, severity evaluation, preoperative planning, and postoperative follow-up. Appropriate techniques are echocardiography, magnetic resonance imaging, computed tomography angiography, and intravascular ultrasound (IVUS). Rarely, IVUS may be needed in patients with potentially serious CAAs and has unique advantages and limitations. IVUS data are essential for in-depth knowledge of mechanisms of coronary dysfunction (exercise-related dynamic stenosis of variable severity) and for indicating interventional treatment. In adolescents or adults, intramural course of an anomalous coronary artery is the only important feature accompanied by stenosis of potential severity and is especially relevant in patients with a high-risk status (elite sport athletes, military recruits).

Citing Articles

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References

Eckart R, Scoville S, Campbell C, Shry E, Stajduhar K, Potter R . Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004; 141(11):829-34. DOI: 10.7326/0003-4819-141-11-200412070-00005. View

Angelini P, Flamm S . Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults. Catheter Cardiovasc Interv. 2007; 69(7):942-54. DOI: 10.1002/ccd.21140. View

Maron B, Doerer J, Haas T, Tierney D, Mueller F . Sudden deaths in young competitive athletes: analysis of 1866 deaths in the United States, 1980-2006. Circulation. 2009; 119(8):1085-92. DOI: 10.1161/CIRCULATIONAHA.108.804617. View

Harmon K, Asif I, Klossner D, Drezner J . Incidence of sudden cardiac death in National Collegiate Athletic Association athletes. Circulation. 2011; 123(15):1594-600. DOI: 10.1161/CIRCULATIONAHA.110.004622. View

Poynter J, Williams W, McIntyre S, Brothers J, Jacobs M . Anomalous aortic origin of a coronary artery: a report from the Congenital Heart Surgeons Society Registry. World J Pediatr Congenit Heart Surg. 2014; 5(1):22-30. DOI: 10.1177/2150135113516984. View

Toresdahl B, Rao A, Harmon K, Drezner J . Incidence of sudden cardiac arrest in high school student athletes on school campus. Heart Rhythm. 2014; 11(7):1190-4. DOI: 10.1016/j.hrthm.2014.04.017. View

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. DOI: 10.1161/CIRCIMAGING.113.000278. View

Angelini P, Uribe C, Monge J, Tobis J, Elayda M, Willerson J . Origin of the right coronary artery from the opposite sinus of Valsalva in adults: characterization by intravascular ultrasonography at baseline and after stent angioplasty. Catheter Cardiovasc Interv. 2015; 86(2):199-208. PMC: 4657462. DOI: 10.1002/ccd.26069. View

Angelini P . Normal and anomalous coronary arteries: definitions and classification. Am Heart J. 1989; 117(2):418-34. DOI: 10.1016/0002-8703(89)90789-8. View

10.

Lee S, Yu C, Park K, Park K, Suh J, Cho Y . Physiological and clinical relevance of anomalous right coronary artery originating from left sinus of Valsalva in adults. Heart. 2015; 102(2):114-9. DOI: 10.1136/heartjnl-2015-308488. View

11.

Smallman D, Webber B, Mazuchowski E, Scher A, Jones S, Cantrell J . Sudden cardiac death associated with physical exertion in the US military, 2005-2010. Br J Sports Med. 2015; 50(2):118-23. DOI: 10.1136/bjsports-2015-094900. View

12.

Grani C, Benz D, Schmied C, Vontobel J, Mikulicic F, Possner M . Hybrid CCTA/SPECT myocardial perfusion imaging findings in patients with anomalous origin of coronary arteries from the opposite sinus and suspected concomitant coronary artery disease. J Nucl Cardiol. 2015; 24(1):226-234. DOI: 10.1007/s12350-015-0342-x. View

13.

Angelini P . Is Echocardiography Adequate to Identify the Severity of Anomalous Coronary Arteries?. JACC Cardiovasc Imaging. 2016; 9(7):898-899. DOI: 10.1016/j.jcmg.2015.12.010. View

14.

Angelini P, Cheong B, Lenge De Rosen V, Lopez J, Uribe C, Masso A . Magnetic Resonance Imaging-Based Screening Study in a General Population of Adolescents. J Am Coll Cardiol. 2018; 71(5):579-580. DOI: 10.1016/j.jacc.2017.11.051. View

15.

Angelini P, Uribe C . Anatomic spectrum of left coronary artery anomalies and associated mechanisms of coronary insufficiency. Catheter Cardiovasc Interv. 2018; 92(2):313-321. DOI: 10.1002/ccd.27656. View

16.

Malhotra A, Dhutia H, Finocchiaro G, Gati S, Beasley I, Clift P . Outcomes of Cardiac Screening in Adolescent Soccer Players. N Engl J Med. 2018; 379(6):524-534. DOI: 10.1056/NEJMoa1714719. View

17.

Angelini P, Cheong B, Lenge De Rosen V, Lopez A, Uribe C, Masso A . High-Risk Cardiovascular Conditions in Sports-Related Sudden Death: Prevalence in 5,169 Schoolchildren Screened via Cardiac Magnetic Resonance. Tex Heart Inst J. 2018; 45(4):205-213. PMC: 6183627. DOI: 10.14503/THIJ-18-6645. View