4D MDCT in the assessment of the tricuspid valve and its spatial relationship with the right coronary artery: A customized tool based on computed tomography for the planning of percutaneous procedures

Összefoglaló. Bevezetés: Congenitalis coronariaanomáliának tekintik azokat a coronariamorfológiai rendellenességeket, melyek 1%-nál kisebb gyakorisággal fordulnak elő. Többségük nem jár tünettel, olykor azonban okozhatnak mellkasi fájdalmat, eszméletvesztést, és hirtelen halálhoz is vezethetnek. A coronariaanomáliák gyakoriságáról Magyarországon eddig csak invazív koronarográfiás adatok alapján jelent meg közlemény. Célkitűzés: Jelen vizsgálatunkban a coronariák eredési rendellenességeinek gyakoriságát mértük fel intézetünk coronaria-komputertomográfiás angiográfián átesett betegeinél. Módszer: A coronaria-komputertomográfiás vizsgálatra került betegek felvételeinek értékelésekor rögzítettük a coronariaanomália jelenlétét. A vizsgálat indikációja általában mellkasi fájdalom volt. 128 szeletes berendezést használtunk, a vizsgálatok során részben retrospektív, részben prospektív EKG-kapuzást alkalmaztunk. Eredmények: 1751 beteg komputertomográfiás angiográfiás felvételeit elemeztük. A betegek között a férfiak aránya 38,4%, a vizsgálatra kerülők életkorának átlaga pedig 58,07 ± 11,07 év volt. Eredési anomáliát 1,83%-ban találtunk, ezen belül a leggyakoribb volt a körbefutó ág (ramus circumflexus) és az elülső leszálló ág különálló eredése a bal Valsalva-sinusból (1%). A további rendellenességek a következők voltak: a jobb coronaria eredése magasan az aortából (0,34%), ramus circumflexus a jobb sinusból vagy a jobb coronariából (0,34%), jobb coronaria a bal Valsalva-sinusból (0,057%), elülső leszálló ág részben a bal Valsalva-sinusból a circumflexustól külön, részben a jobb coronariából (kettős elülső leszálló ág, 0,057%). Következtetés: Mindössze 0,057%-ban fordult elő potenciálisan tünetet okozó coronariaeredési rendellenesség (a bal sinusból eredő jobb coronaria). A komputertomográfiás angiográfia segítségével a coronariaeredés helye pontosan megállapítható, tisztázható az ér lefutása és ennek során viszonya a környező struktúrákhoz. Orv Hetil. 2020; 161(47): 1995–1999. Summary. Introduction: Congenital coronary artery anomaly is defined as a coronary morphology which occurs in less than 1% of the cases. Usually these anomalies do not result in symptoms but sometimes they can cause chest pain, syncope and sudden death. In Hungary, the prevalence of these abnormalities was published only from data of invasive coronary angiography. Objective: In this study, we evaluated the prevalence of the anomalies of coronary origin in the patients of our institution undergoing coronary computed tomography. Method: While reading the computed tomography angiograms of our patients, we registered the presence of coronary anomalies. In most of the cases, the indication of the coronary computed tomography was chest pain. A scanner with 128 detectors was used, scans were performed partly with prospective, partly with retrospective ECG gating. Results: We assessed 1751 patients. The ratio of males was 38.4%, while the average age of patients 58.07 ± 11.07 years. Anomaly of coronary origin was present in 1.83% of our patients, with the separate origin of left anterior descending and left circumflex artery being the most frequent (1%) among them. Other anomalies were as follows: high take-off of the right coronary artery from the ascending aorta (0.34%), left circumflex arising from the right sinus of Valsalva or from the right coronary (0.34%), right coronary artery from the left sinus of Valsalva (0.057%), left anterior descending arising partly from the left sinus of Valsalva, apart from the left circumflex, partly from the right coronary (dual left anterior descending artery, 0.057%). Conclusion: The prevalence of potentially symptomatic coronary anomalies was only 0.057% in our series (right coronary from the left sinus of Valsalva). The computed tomography angiography can precisely define the origin of the coronary artery, depict its run-off and its relationship to the neighbouring structures. Orv Hetil. 2020; 161(47): 1995–1999.

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Aortic dissection during transoesophageal echocardiography: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytaa333 ◽

2020 ◽

Author(s):

Rin Hoshina ◽

Hideyuki Kishima ◽

Takanao Mine ◽

Masaharu Ishihara

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Aortic Dissection ◽

Right Coronary Artery ◽

Bypass Graft ◽

Transoesophageal Echocardiography ◽

Ascending Aorta ◽

Maximum Diameter ◽

Abnormal Finding ◽

The Right

Abstract Background Transoesophageal echocardiography (TOE) is a safe and useful tool. In our case, we are presenting a rare case of a patient with aortic dissection during TOE procedure. Case summary A 79-year-old woman was referred to our hospital for recurrent paroxysmal atrial fibrillation (AF) with palpitation. Pre-procedural cardiac computed tomography (CT) showed slight dilated ascending aorta (maximum diameter: 40 mm). We decided to perform catheter ablation (CA) for AF, and recommended TOE before the CA because she had a CHADS2 score of 4. On the day before the CA, TOE was performed. Her physical examinations at the time of TOE procedure were unremarkable. At 3 min after probe insertion, there was no abnormal finding of the ascending aorta. At 5 min after the insertion, TOE showed ascending aortic dissection without pericardial effusion. After waking, she had severe back pain and underwent a contrast-enhanced CT. Computed tomography demonstrated Stanford type A aortic dissection extending from the aortic root to the bifurcation of common iliac arteries, and tight stenosis in the right coronary artery (maximum diameter; 49 mm). The patient underwent a replacement of the ascending aorta, and a coronary artery bypass graft surgery for the right coronary artery. Discussion Transoesophageal echocardiography would have to be performed under sufficient sedation with continuous blood pressure monitoring in patients who have risk factors of aortic dissection. The risk–benefit of TOE must be considered before a decision is made. Depending on the situation, another modality instead of TOE might be required.

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Absence of the right coronary artery detected by 64-detector-row multislice computed tomography

International Journal of Cardiology ◽

10.1016/j.ijcard.2006.01.039 ◽

2007 ◽

Vol 115 (2) ◽

pp. 249-250 ◽

Cited By ~ 1

Author(s):

Taeko Kunimasa ◽

Yuichi Sato ◽

Shingo Ito ◽

Takuro Takagi ◽

Tetsuo Lee ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Right Coronary Artery ◽

Multislice Computed Tomography ◽

The Right

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Diagnosis of anomalous origin of the right coronary artery using multislice computed tomography: evaluation of possible causes of myocardial ischemia

Heart and Vessels ◽

10.1007/s00380-005-0826-8 ◽

2005 ◽

Vol 20 (6) ◽

pp. 298-300 ◽

Cited By ~ 21

Author(s):

Yuichi Sato ◽

Fumio Inoue ◽

Taeko Kunimasa ◽

Naoya Matsumoto ◽

Shunichi Yoda ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Myocardial Ischemia ◽

Right Coronary Artery ◽

Multislice Computed Tomography ◽

Anomalous Origin ◽

The Right

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Defective regional myocardial development and vascularization in one variant of tricuspid atresia—clinical and necropsy findings in three cases

Cardiology in the Young ◽

10.1017/s1047951100000573 ◽

1992 ◽

Vol 2 (1) ◽

pp. 42-52 ◽

Cited By ~ 3

Author(s):

William N. O'Connor ◽

Carol M. Cottrill ◽

Michael T. Marion ◽

Jacqueline A. Noonan

Keyword(s):

Coronary Artery ◽

Right Ventricle ◽

Tricuspid Valve ◽

Right Coronary Artery ◽

Interventricular Septum ◽

Ventricular Myocardium ◽

Tricuspid Atresia ◽

Subaortic Stenosis ◽

Myocardial Development ◽

The Right

SummaryFive previously reported cases have established the combination of a small right ventricle (sometimes with Uhl's anomaly), imperforate tricuspid valve with fibrotic tensor apparatus, congenital absence of the pulmonary valve, and an intact interventricular septum with muscular subaortic stenosis as a rare variant of tricuspid atresia. In this study of three new autopsy cases, we additionally identified Ebstein's malformation of the imperforate tricuspid valve, partial Uhl's anomaly, regional dysplasia of right ventricular myocardium and thinning of the interventricular septum by intramyocardial sinusoids from the right ventricle. All three new cases had epicardial anomalies of the right coronary artery—a fistula to right ventricle, ostial stenosis and proximal arterial hypoplasia. Sinusoidal connections from the right ventricle to the right coronary artery and to the sclerotic left anterior descending artery were identified in serial sections of the right ventricle and septum. Myofiber disarray, with thick walled intramyocardial arteries and sinusoids from left ventricle, involved the bulging subaortic interventricular septum. These studies are consistent with the hypothesis that defective development of the the right ventricle, along with its blood supply and associated atrioventricular and arterial valves, may underlie this unusual form of congenital heart disease.

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A Case of Acute Thrombotic Occlusion of an Anomalous Origin of the Right Coronary Artery From the Left Coronary Sinus: Focus on the Importance of Dual-Source Computed Tomography for Failed Emergency Coronary Angiography

Canadian Journal of Cardiology ◽

10.1016/j.cjca.2012.03.009 ◽

2012 ◽

Vol 28 (6) ◽

pp. 759.e5-759.e7 ◽

Cited By ~ 2

Author(s):

Hyeong Kug Kim ◽

Yu Jeong Choi ◽

Ki-Woon Kang ◽

Jin A. Lee ◽

Se Young Park ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Coronary Angiography ◽

Right Coronary Artery ◽

Coronary Sinus ◽

Anomalous Origin ◽

Thrombotic Occlusion ◽

Dual Source ◽

The Right ◽

Dual Source Computed Tomography

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Coronary angiography and dual-source computed tomography are complementary methods in diagnosis of significant stenosis of the right coronary artery originating from the left aortic sinus

Open Medicine ◽

10.2478/s11536-007-0053-z ◽

2008 ◽

Vol 3 (1) ◽

pp. 111-114 ◽

Cited By ~ 1

Author(s):

Josef Veselka ◽

David Zemánek ◽

Radka Duchoňová ◽

Peter Blaško ◽

Theodor Adla ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Artery ◽

Right Coronary Artery ◽

Therapeutic Process ◽

Aortic Sinus ◽

Computed Tomographic ◽

Dual Source ◽

The Right ◽

Case Diagnosis ◽

Dual Source Computed Tomography

AbstractAnomalous origin of the right coronary artery from the contralateral aortic sinus is a rare but potentially fatal congenital abnormality. We analyzed 8.066 consecutive coronary angiograms and found 4 cases demonstrating this anomaly. In 2 cases the right coronary artery was without significant atherosclerotic lesions and coursed between the aorta and pulmonary trunk. In the 2 other cases the right coronary artery was significantly stenosed. In the last case, diagnosis was based on angiographic and dual-source computed tomographic examinations. Dual-source computed tomography showed precisely the origin and course of the right coronary artery between the ascending aorta and pulmonary artery. Moreover, stenoses of the anomalous coronary artery were depicted. Subsequent coronary interventions required modification of the Amplatz left guiding catheter, which enabled a sufficient support even for coronary artery stenting. Both methods seem to be complementary in the diagnostic and therapeutic process of this coronary anomaly.

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