Cardiovascular Computed Tomographic Angiography as a Virtual Patient Avatar for Individualized Surgical Planning of Complex Anomalous Coronary Artery Anatomy

2019 ◽  
Vol 10 (4) ◽  
pp. 502-503
Author(s):  
Jerold S. Shinbane ◽  
Craig Baker ◽  
Farhood Saremi ◽  
Vaughn Starnes

Cardiovascular computed tomographic angiography (CCTA) 3-D thoracic reconstruction can serve as a “virtual patient avatar” providing surgical views for approach to complex anomalous coronary artery anatomy. Images demonstrated a single coronary artery ostium arising from the right aortic sinus with trifurcation into a prepulmonic left anterior descending coronary artery (LAD), an interarterial circumflex with a subsequent intraseptal course, and normal course of the right coronary artery. Virtual 3-D CCTA reconstructions were important to planning an incisional plane for surgical correction.

2017 ◽  
Vol 44 (5) ◽  
pp. 312-319
Author(s):  
Xiujian Liu ◽  
Guanghui Wu ◽  
Chuangye Xu ◽  
Yuna He ◽  
Lixia Shu ◽  
...  

Understanding plaque formation in patients at risk for coronary artery disease—the leading cause of morbidity and death in the world—enables physicians to better determine whether and how to treat these individuals. We used computed tomographic angiography to quantitatively evaluate the progression of nonculprit coronary plaques along the full length of the right coronary artery in 21 patients with acute coronary syndrome. Each right coronary artery was analyzed in sequential, 3-mm-long segments, and the minimum luminal area, plaque burden, and plaque volume within each segment were evaluated at baseline and at 12-month follow-up. Serial remodeling of the right coronary artery was also evaluated. In total, 625 arterial segments were analyzed. At 12-month follow-up, the plaque burden had increased slightly by 0.34% (interquartile range [IQR], −4.32% to 6.35%; P=0.02), and the plaque volume was not significantly changed (0.33 mm3; IQR, −3.05 to 3.54; P=0.213). The minimum luminal area decreased 0.05 mm2 (IQR, −1.33 to 0.87 mm2; P=0.012), and this was accompanied by vessel reduction, as evidenced by negative remodeling in 43% of the 625 segments. We conclude that serial computed tomographic angiography can be used to quantitatively evaluate the morphologic progression of coronary plaques.


Author(s):  
Suhail Rafiq ◽  
Irshad Mohiuddin ◽  
Imran Nazir ◽  
Malik Faizan

Background: Coronary Artery Anomalies (CAAs) presenting in adulthood are rare and associated with adverse cardiac events, including sudden cardiac death. Coronary artery anomaly is the second most common cause of Sudden Cardiac Death (SCD) in young athletes. Cardiac Computed Tomographic Angiography (CTA) is a readily available non-invasive imaging modality that provides high-resolution anatomical information of the coronary arteries. Multi-detector row CT is superior to conventional angiography in defining the ostial origin and proximal path of anomalous coronary branches.Methods: This was a prospective study included 186 patients who underwent coronary CTA from December 2018 to November 2019 in Government medical College, Srinagar on a 256 slice CT. The indications for coronary CTA were an equivocal, or non-diagnostic stress test, atypical chest pain, suspected anomalous coronary, as well as the evaluation of cardiac cause of syncope.Results: Ramus intermedius was the most common anatomical variant seen in 25 patients (13.4%). The prevalence of coronary anomalies in this study was 5.66% including myocarding bridging. The most common anomaly was high take off of coronary artery from sinotubular junction accounting for 1.6%.Conclusions: Coronary Computed Tomographic angiography is much superior in detecting coronary artery anomalies than invasive coronary angiography because of the absence of soft tissue information like as is needed in myocardial bridging. Proper knowledge of the anomalies and their clinical significance is highly important in planning treatment and easing hardships of cardiologists in dealing with them.


2021 ◽  
pp. 154431672110023
Author(s):  
Winnie Nguyen ◽  
Tammy Albanese ◽  
Vanessa Tran ◽  
Anne Moore ◽  
Laligam Sekhar

This is a case report of a 35-year-old female pedestrian struck by a semi-truck. computed tomographic angiography (CTA) revealed a pseudoaneurysm at the proximal brachiocephalic artery measuring 1.8 cm in cranio-caudal length and 1.2 × 0.6 cm transverse. Just distal to the pseudoaneurysm, there was severe luminal narrowing caused by either a dissection flap or mural thrombus. Due to profound left-sided weakness, transcranial Doppler ultrasound was performed which demonstrated “hesitant” waveforms in the right middle cerebral and right vertebral arteries secondary to proximal obstruction. Hesitant waveforms display mid-systolic velocity deceleration and may also be referred to as the “bunny” waveform. Emboli monitoring of the right middle cerebral and basilar arteries were positive for active embolization


Author(s):  
Suvipaporn Siripornpitak ◽  
Apichaya Sriprachyakul ◽  
Worakan Promphan ◽  
Pirapat Mokarapong ◽  
Suthep Wanitkun

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