Coronary anomalies

2018 ◽  
Author(s):  
Cristina Basso ◽  
José Maria Perèz-Pomares ◽  
Gaetano Thiene ◽  
Lucile Houyel
Keyword(s):  
Coronary Artery ◽  
Heart Defects ◽  
Pulmonary Atresia ◽  
Great Artery ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Left Heart Syndrome ◽  
Congenitally Corrected Transposition ◽  
Arterial Anatomy ◽  
Corrected Transposition

Coronary artery anomalies occur either in isolation or in the context of congenital heart defects (CHD). Isolated coronary artery anomalies include anomalies of connection to the pulmonary artery or to the aorta, anomalies of the intrinsic coronary arterial anatomy including anomalous orifices, and anomalies of myocardial/coronary arterial interaction including myocardial bridges and fistulae. Such defects are of major significance in clinical cardiology and cardiac surgery because of their association with myocardial ischaemia and sudden death. Coronary anomalies associated with CHD can result from three types of developmental perturbation: (1) anomalous epicardial course (in congenitally corrected transposition of the great arteries and L-looped ventricles), (2) anomalous communication with a high-pressure ventricular cavity (pulmonary atresia with intact ventricular septum and hypoplastic left heart syndrome), or (3) anomalous connection to the aorta. Outflow tract defects represents 30–40% of CHD, and their main characteristic is great artery defects influencing coronary arterial anatomy.

scholarly journals Anomalous Right Coronary Originating from the Left main Coronary or the mid of Left Anterior Descending Coronary Artery

2021 ◽  
Vol 4 (2) ◽  
pp. 01-09
Author(s):  
Xuju Qin ◽  
Lin Yang ◽  
Weiguo Xiong ◽  
Chunpeng Lu ◽  
Xuguang Qin
Keyword(s):  
Coronary Artery ◽  
Sinus Of Valsalva ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Left Main ◽  
Clinical Presentations ◽  
Competitive Athletes ◽  
Bifurcation Lesions ◽  
Arterial Anatomy ◽  
Left Sinus Of Valsalva

Coronary artery anomalies (CAAs) are very rare a relatively uncommon, diverse group of congenital disorders of coronary arterial anatomy with a clinical presentations. Though most commonly detected incidentally finding during routine catheter, CT angiograms or at autopsy, these anomalies have generated considerable interest as they constitute the second most common cause of sudden cardiac death in young competitive athletes after hypertrophic cardiomyopathy1. Their prevalence ranges from 0.2% to 1.3% based published series 2-4. The most common coronary artery anomaly is origination of the left circumflex coronary (LCX) artery from the proximal of right coronary artery (RCA) or right sinus of Valsalva. The second is separate origination of the left anterior descending coronary artery (LAD) and LCX artery from the left sinus of Valsalva. Herein, we present five cases that the anomalous RCA arises from the left main coronary artery or the mid of left left anterior descending coronary artery (LAD). These cases are extremely rare. we bring forth them in an attempt to highlight their significance, and make cardiologist to understand what important the anomalies are, and how to diagnosis and treatment these bifurcation lesions of coronary anomalies.

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

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.

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

2017 ◽  
Vol 27 (8) ◽  
pp. 1529-1537 ◽  
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.

scholarly journals Coronary artery anomalies in North Indian population: a conventional coronary angiographic study

2017 ◽  
Vol 06 (04) ◽  
pp. 250-257
Author(s):  
Yogesh Diwan ◽  
Deepa Diwan ◽  
Randhir S. Chauhan ◽  
Prakash C. Negi
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Indian Population ◽  
Tertiary Care ◽  
Clinical Aspects ◽  
Single Coronary Artery ◽  
North Indian Population ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Artery Disease

Abstract Background: Anomalies of origin and course of one or both coronary arteries, with or without symptoms, are of special interest for anatomists, interventional cardiologists, and cardiac surgeons. Aims: To estimate the prevalence of coronary anomalies and their clinical aspects in North Indian population. Material and Methods: Study was done on patients undergoing coronary angiography for suspected coronary artery disease or for coronary intervention at a tertiary care centre in North India. Results: A total of 1130 patients [803 males, 327 females and mean age 57.37°10.60 years] were reviewed for coronary artery anomalies. Overall incidence of Coronary artery anomalies was 13 [1.15%] and was 1% in men and 1.53% in women. 38.46% of these patients were found to have ectopic origin of left circumflex [LCx] and in 23.08% of cases, ectopic origin of right coronary artery [RCA] was noted. Separate orifice for left anterior descending [LAD] and LCx in left coronary sinus [LCS] was observed in 0.27% cases, coronary artery fistula [CAF] in 0.09% cases and single coronary artery from LCS was found in 0.09% cases. Conclusions: The most common coronary anomalies were origin of LCx from RCA and presence of separate orifice for LAD and LCx in LCS. Dominance, gender and coronary artery disease [CAD] have no association with coronary anomalies.

Incidental congenitally corrected transposition of the great arteries (ccTGA) in an adult with suspected coronary artery disease: review on radiological features and pathophysiology

2020 ◽  
Vol 13 (4) ◽  
pp. e234225
Author(s):  
Khairil Amir Sayuti ◽  
Mohd Yadie Syazwan Bin Azizi
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Ventricular Hypertrophy ◽  
Suspected Coronary Artery Disease ◽  
Left Ventricular ◽  
Radiological Features ◽  
Peripheral Hospital ◽  
Artery Disease ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

We report a case of a 46-year-old woman who has presented to a peripheral hospital with progressive exertional dyspnoea and chest discomfort. The resting ECG showed features of left-sided ventricular hypertrophy. The initial chest radiograph was reported as cardiomegaly. Initial echocardiography revealed left atrial dilatation and ‘left ventricular’ hypertrophy with normal ejection fraction. She was treated as possible coronary artery disease and was subsequently referred to our centre for CT coronary angiography. Findings from the CT scan were consistent with congenitally corrected transposition of the great arteries (ccTGA). This report describes the radiological features of ccTGA, its associated cardiovascular anomalies, pathophysiology and potential complications.

Management and Anesthetic Considerations for Patients With Anomalous Aortic Origin of a Coronary Artery

2018 ◽  
Vol 22 (4) ◽  
pp. 383-394 ◽  
Author(s):  
Benjamin Kloesel ◽  
Martina Richtsfeld ◽  
Mojca Konia ◽  
John L. Bass
Keyword(s):  
Coronary Artery ◽  
Risk Stratification ◽  
Coronary Arteries ◽  
Anesthetic Management ◽  
Heterogeneous Group ◽  
Coronary Anomalies ◽  
Disease Group ◽  
Coronary Artery Anomalies ◽  
Fatal Disease ◽  
Anesthetic Considerations

The term “coronary artery anomalies” encompasses a large and heterogeneous group of disorders that may affect origin, intrinsic anatomy, course, location, and termination of the coronary arteries. With these different anatomies, presentation, symptoms, and outcomes are heterogeneous as well. While significant efforts are directed toward improving diagnosis and risk-stratification, best evidence-guided practices remain in evolution. Data about anesthetic management of patients with coronary anomalies are lacking as well. This review aims to provide the anesthesiologist with a better understanding of an important subgroup of coronary artery anomalies: anomalous aortic origin of a coronary artery. We will discuss classification, pathophysiology, incidence, evaluation, management, and anesthetic implications of this potentially fatal disease group.

Ischaemic heart disease: coronary artery anomalies

2016 ◽  
Author(s):  
Eugenio Picano ◽  
Fausto Pinto ◽  
Blazej Michalski
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Cardiac Death ◽  
Incidental Finding ◽  
Superior Vena ◽  
Vena Cava ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Venous Structure ◽  
Coronary Artery Segment

Coronary anomalies occur in less than 1% of the general population and their clinical presentation can range anywhere from a benign incidental finding to the cause of sudden cardiac death. Since congenital coronary arteries anomalies are often considered as the first cause of cardiac death in young athletes in Europe, careful attention has to be paid in this specific subpopulation in case of suggestive symptoms. Although focused expert echocardiography is the first-line imaging tool, coronary computed tomography or radiation-free magnetic resonance imaging are recommended for more definitive definition of the coronary course in persons suspected of having coronary artery anomalies. Most coronary anomalies belong to the group of anomalous origin. Aneurysms are defined as dilations of a coronary vessel 1.5 times the normal adjacent coronary artery segment. Coronary artery fistulas are communications between one or more coronary arteries and a cardiac chamber (coronary-cameral), the pulmonary artery, or a venous structure (such as the sinus or superior vena cava).

P5685Abnormal anatomy of the coronary sinus in congenitally corrected transposition of the great arteries (double discordance): a pitfall for transvenous cardiac resynchronization therapy?

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Houyel ◽  
N Arribard ◽  
M Mostefa Kara ◽  
B Bessieres ◽  
D Bonnet
Keyword(s):  
Cardiac Resynchronization Therapy ◽  
Coronary Sinus ◽  
Pulmonary Atresia ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Coronary Veins ◽  
Segmental Anatomy ◽  
Cardiac Veins ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

Abstract Background Congenitally corrected transposition of the great arteries (ccTGA) or double discordance is a rare congenital heart defect associating discordant atrioventricular and ventriculoarterial connections. Late prognosis depends on the progressive failure of the systemic right ventricle (RV). A possible cause for systemic RV dysfunction could be ventricular asynchrony. Cardiac resynchronization therapy (CRT) may thus be indicated in some cases. However, the cardiologists may experience some problems with the coronary sinus (CS) when implanting a 3-lead CRT transvenous system in these patients. Aim of the study To evaluate the anatomy of the CS and cardiac veins in specimens with ccTGA, in order to assess the feasibility of transvenous CRT. Material and methods Among the anatomic collection of the French Centre of Reference for complex CHD, 51 heart specimens had ccTGA with 2 ventricles. There were 33 post-natal and 18 fetal hearts. Hearts were reviewed with special attention paid to the course and drainage of the CS and cardiac veins. Segmental anatomy, location of the ventricular septal defect (VSD), status of the pulmonary outflow tract and anomalies of the atrioventricular valves were reviewed. Results Segmental anatomy was {S,L,L} in 46/51 hearts, {S,L,D} in 2 and {I,D,D} in 3. There was a VSD in 40 (outlet in 25, inlet in 11, both in 2, muscular in 2), pulmonary atresia in 13, subpulmonary stenosis in 6, abnormal tricuspid valve in 20/48 including Ebstein anomaly in 6, straddling in 9 (3 had replacement). The CS was always located behind the morphologically left atrium (LA). However, its anatomy was normal, with normal drainage into the morphologically right atrium, in only 25/51 (49% of cases). The CS was of reduced length with normal orifice in 17. Orifice was atretic with normal size CS in 2, and CS was completely absent in 6 with direct drainage of coronary veins into the LA. At least 1 available vein was found in all cases with patent CS orifice. Conclusion CS in ccTGA is always located behind the morphologically LA. However, its anatomy is abnormal in half of cases. The most frequent anomalies are reduced length (33%) and absent CS or atretic orifice (15.5%). The anatomy of CS should therefore be assessed by imaging techniques (multislice CT imaging or CS venography) before considering transvenous CRT in these patients.

scholarly journals Prevalence of congenital coronary artery anomalies as shown by multi-slice computed tomography coronary angiography: a single-centre study from Turkey

2016 ◽  
Vol 44 (6) ◽  
pp. 1492-1505 ◽  
Author(s):  
Aybala Tongut ◽  
Zeki Özyedek ◽  
İsmail Çerezci ◽  
Selim Erentürk ◽  
Ali Can Hatemi
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Demographic Data ◽  
Coronary Anomalies ◽  
Coronary Artery Anomalies ◽  
Single Centre ◽  
Centre Study ◽  
Single Centre Study ◽  
Group 3 ◽  
Group 2

Objective Coronary artery anomaly (CAA) is a remarkable etiological factor for sudden cardiac death in young adults. The incidence of CAA is unknown, with most reliable data available based on postmortem/angiography investigations. This study aimed to assess the prevalence of different forms of coronary anomalies, and to investigate the relationships between demographic data and occurrence of CAA. Methods A total of 2401 consecutive patients (1805 men; mean age, 56 ± 11.7 years), who were referred between January 2005 and December 2008 for noninvasive multi-slice computed tomography (MSCT) imaging, were retrospectively analysed. Results A total of 225 cases (191 men; mean age, 55.9 ± 12) of CAAs were identified (9.37%). Because 11 patients had multiple muscular bridges of the coronary arteries, 236 coronary artery anomalies were found in these 225 patients. Cases were classified into three groups: group 1, coronary anomalies of origin and distribution (n = 36, 1.5%); group 2, anomalies of intrinsic coronary arterial anatomy (n = 180, 7.49%); and group 3, anomalies of coronary termination (n = 9, 0.4%). Conclusion The prevalence of CAA was 9.37% in our single-centre study, which is consistent with previous research. A minimally invasive tool, such as MSCT angiography, should be used to identify CAA.

3D Printing to Model Surgical Repair of Complex Congenitally Corrected Transposition of the Great Arteries

2017 ◽  
Vol 10 (3) ◽  
pp. 373-375 ◽  
Author(s):  
R. Anto Sahayaraj ◽  
Sowmya Ramanan ◽  
Raghavan Subramanyan ◽  
Kotturathu Mammen Cherian
Keyword(s):  
Pulmonary Artery ◽  
Pulmonary Arteries ◽  
Three Dimensional ◽  
Pulmonary Atresia ◽  
Aortic Homograft ◽  
3D Printed ◽  
Valved Conduit ◽  
Bovine Jugular Vein ◽  
Congenitally Corrected Transposition ◽  
Corrected Transposition

We report the use of three-dimensional (3D) modeling to plan surgery for physiologic repair of congenitally corrected transposition of the great arteries with pulmonary atresia, dextrocardia, and complex intra cardiac anatomy. Based on measurements made from the 3D printed model of the actual patient’s anatomy, we anticipated using a composite valved conduit (Dacron tube graft, decellularized bovine jugular vein, and aortic homograft) to establish left ventricle-to-pulmonary artery continuity with relief of stenosis involving the pulmonary artery confluence and bilateral branch pulmonary arteries.

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