Screening for proximal coronary artery anomalies with 3-dimensional MR coronary angiography

Purpose.Until the mid-20th century they could be discovered only during autopsy, it means after death. With the introduction of coronary angiography it become possible to find them in a living person. Later on, new modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) enhanced futher our abilities. It is very important to discover coronary anomalies in a living person, because some of them could lead to sudden cardiac death (SCD). In fact, coronary artery anomalies are the second main cause of the SCD in young athletes. Another importance is driven by the fact, that some of them could lead to lifethreatening complications during cardiac surgery when unknown before the operation.Methods.We prospectively reviewed all coronary angiography films from 2011 to 2016 in our center. Coronary anomalies were reviewed and classified by two independent experienced operators. Patients with congenital heart disease and coronary fistulas were excluded.Results.Out of 5055 patients 148 (2.9%) had coronary artery anomalies of origin and distribution. Those were 120 men (81.1%) and 28 women (18.9%) with an age range between 29 to 88 years. The three most common anomalies were myocardial bridge (48.7%), separate origin of the conus branch (13.5%) and separate origin of the LAD and LCX (8.1%).Conclusion.In our study we found more or less the same types and incidence rates of coronary artery anomalies as in the world literature. We had apparently higher rates of myocardial bridges, compared to average number on angiography studies, but very close to authopsy study rates.

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Quantitative evaluation and comparison of coronary artery characteristics by 3D coronary volume reconstruction

Scientific Reports ◽

10.1038/s41598-020-80928-4 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Yongcheol Kim ◽

Jonathan James Hyett Bray ◽

Benjamin Waterhouse ◽

Alexander Gall ◽

Georgia May Connolly ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Coronary Arteries ◽

Intraclass Correlation ◽

Quantitative Coronary Angiography ◽

Volume Estimation ◽

Diabetic Patients ◽

Volume Reconstruction ◽

3 Dimensional ◽

Inter Observer Variability

AbstractNon-atherosclerotic abnormalities of vessel calibre, aneurysm and ectasia, are challenging to quantify and are often overlooked in qualitative reporting. Utilising a novel 3-dimensional (3D) quantitative coronary angiography (QCA) application, we have evaluated the characteristics of normal, diabetic and aneurysmal or ectatic coronary arteries. We selected 131 individuals under 50 years-of-age, who had undergone coronary angiography for suspected myocardial ischaemia between 1st January 2011 and 31st December 2015, at the Bristol Heart Institute, Bristol, UK. This included 42 patients with angiographically normal coronary arteries, 36 diabetic patients with unobstructed coronaries, and 53 patients with abnormal coronary dilatation (aneurysm and ectasia). A total of 1105 coronary segments were analysed using QAngio XA 3D (Research Edition, Medis medical imaging systems, Leiden, The Netherlands). The combined volume of the major coronary arteries was significantly different between each group (1240 ± 476 mm3 diabetic group, 1646 ± 391 mm3 normal group, and 2072 ± 687 mm3 abnormal group). Moreover, the combined coronary artery volumes correlated with patient body surface area (r = 0.483, p < 0.01). Inter-observer variability was assessed and intraclass correlation coefficient of the total coronary artery volume demonstrated a low variability of 3D QCA (r = 0.996, p < 0.001). Dedicated 3D QCA facilitates reproducible coronary artery volume estimation and allows discrimination of normal and diseased vessels.

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