MULTIMODALITY IMAGING IN CORONARY ARTERY ANOMALIES

Coronary artery anomalies (CAAs) are a group of congenital conditions characterized by abnormal origin or course of any of the 3 main epicardial coronary arteries. Although CAAs have been identified as a common underlying condition in young athletes with sudden cardiac death, the widespread use of invasive and noninvasive coronary imaging has led to increased recognition of CAAs among adults. CAAS are often discovered as an incidental finding during the diagnostic workup for ischemic heart disease. The clinical correlates and prognostic implication of CAAs remain poorly understood in this context, and guideline-recommended therapeutic choices are supported by a low level of scientific evidence. Several studies have examined whether assessment of CAA-related myocardial ischemia can improve risk stratification in these patients, suggesting that multimodality imaging and functional tests may be key in the management of CAAs. The aim of this review is to outline definitions, classification, and epidemiology of the most relevant CAAs, highlighting recent advances and the potential impact of multimodality evaluation, and to discuss current therapeutic opportunities.

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Epidemiology of coronary abnormalities of discharge and branching and their clinical significance

Medical Visualization ◽

10.24835/1607-0763-2018-6-40-50 ◽

2019 ◽

Vol 22 (6) ◽

pp. 40-50

Author(s):

E. F. Abbasov ◽

S. S. Manafov ◽

F. Z. Abdullayev ◽

F. E. Abbasov ◽

A. G. Akhundova

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

World Literature ◽

Incidence Rates ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Coronary Abnormalities ◽

Magnetic Resonance Imaging Mri ◽

Age Range ◽

Living Person

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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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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