Major coronary artery anomalies in a pediatric population: incidence and clinical importance

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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End-to-End, Pixel-Wise Vessel-Specific Coronary and Aortic Calcium Detection and Scoring Using Deep Learning

Diagnostics ◽

10.3390/diagnostics11020215 ◽

2021 ◽

Vol 11 (2) ◽

pp. 215

Author(s):

Gurpreet Singh ◽

Subhi Al’Aref ◽

Benjamin Lee ◽

Jing Lee ◽

Swee Tan ◽

...

Keyword(s):

Deep Learning ◽

Coronary Artery ◽

Clinical Importance ◽

Learning Model ◽

Mean Difference ◽

Interquartile Range ◽

History Of ◽

End To End ◽

Artery Disease ◽

Deep Learning Model

Conventional scoring and identification methods for coronary artery calcium (CAC) and aortic calcium (AC) result in information loss from the original image and can be time-consuming. In this study, we sought to demonstrate an end-to-end deep learning model as an alternative to the conventional methods. Scans of 377 patients with no history of coronary artery disease (CAD) were obtained and annotated. A deep learning model was trained, tested and validated in a 60:20:20 split. Within the cohort, mean age was 64.2 ± 9.8 years, and 33% were female. Left anterior descending, right coronary artery, left circumflex, triple vessel, and aortic calcifications were present in 74.87%, 55.82%, 57.41%, 46.03%, and 85.41% of patients respectively. An overall Dice score of 0.952 (interquartile range 0.921, 0.981) was achieved. Stratified by subgroups, there was no difference between male (0.948, interquartile range 0.920, 0.981) and female (0.965, interquartile range 0.933, 0.980) patients (p = 0.350), or, between age <65 (0.950, interquartile range 0.913, 0.981) and age ≥65 (0.957, interquartile range 0.930, 0.9778) (p = 0.742). There was good correlation and agreement for CAC prediction (rho = 0.876, p < 0.001), with a mean difference of 11.2% (p = 0.100). AC correlated well (rho = 0.947, p < 0.001), with a mean difference of 9% (p = 0.070). Automated segmentation took approximately 4 s per patient. Taken together, the deep-end learning model was able to robustly identify vessel-specific CAC and AC with high accuracy, and predict Agatston scores that correlated well with manual annotation, facilitating application into areas of research and clinical importance.

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An overview of surgery options for congenital coronary artery anomalies

Future Cardiology ◽

10.2217/fca.10.82 ◽

2010 ◽

Vol 6 (5) ◽

pp. 627-645 ◽

Cited By ~ 6

Author(s):

Constantine Mavroudis ◽

Ali Dodge-Khatami ◽

Robert D Stewart ◽

Marshall L Jacobs ◽

Carl L Backer ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Anomalies ◽

Congenital Coronary Artery Anomalies

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Paediatric-onset coronary artery anomalies in pregnancy: a single-centre experience and systematic literature review

Cardiology in the Young ◽

10.1017/s1047951117000658 ◽

2017 ◽

Vol 27 (8) ◽

pp. 1529-1537 ◽

Cited By ~ 3

Author(s):

Michelle Keir ◽

Catriona Bhagra ◽

Debra Vatenmakher ◽

Francisca Arancibia-Galilea ◽

Katrijn Jansen ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiac Arrest ◽

Coronary Artery ◽

Cardiovascular Events ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Major Cardiovascular Events ◽

Coronary Aneurysms ◽

Increased Risk ◽

In Pregnancy

AbstractObjectivesIndividuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population.MethodsWe performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases. We defined paediatric-onset coronary artery anomalies as congenital coronary anomalies and inflammatory arteriopathies of childhood that cause coronary aneurysms. Major cardiovascular events were defined as pulmonary oedema, sustained arrhythmia requiring treatment, stroke, myocardial infarction, cardiac arrest, or death.ResultsA total of 25 surveys were mailed, and 20 were returned (80% response rate). We included 46 articles from the literature, which described cardiovascular outcomes in 82 women (138 pregnancies). These data were amalgamated for a total of 102 women and 194 pregnancies; 59% of women were known to have paediatric-onset coronary artery anomalies before pregnancy. In 23%, the anomaly was unmasked during or shortly after pregnancy. The remainder, 18%, was diagnosed later in life. Major cardiovascular events occurred in 14 women (14%) and included heart failure (n=5, 5%), myocardial infarction (n=7, 7%), maternal death (n=2, 2%), cardiac arrest secondary to ventricular fibrillation (n=1, 1%), and stroke (n=1, 1%). The majority of maternal events (13/14, 93%) occurred in women with no previous diagnosis of coronary disease.ConclusionsWomen with paediatric-onset coronary artery anomalies have a 14% risk of adverse cardiovascular events in pregnancy, indicating the need for careful assessment and close follow-up. Prospective, multicentre studies are required to better define risk and predictors of complications during pregnancy.

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