Coronary angiography right anterior oblique view reveals the fistula between the proximal left anterior descending artery and the main pulmonary trunk with significant stenosis in the proximal left anterior descending artery

Aim: To determine the prevalence and characteristics of dual left anterior descending artery (LAD) in adults undergoing catheter coronary angiography. Materials & methods: We identified cases with dual LAD by retrospectively analyzing 3233 angiograms done from January 2017 to June 2019. Results: Dual LAD was seen in 22 patients (0.68%). We identified type I dual LAD in 14 cases, type II in 7 cases and type III in 1 case. Significant stenosis was seen in proximal part of long LAD in 12 cases, in LAD proper in 7 cases and in proximal part of short LAD in 4 cases. Conclusion: Dual LAD is a rare anomaly. Its sound knowledge is essential for proper management of patients with coronary artery disease.

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Abstract 365: Left Ventricular Wall Findings in Non-Electrocardiography-Gated Contrast-Enhanced Computed Tomography After Extracorporeal Cardiopulmonary Resuscitation

Circulation ◽

10.1161/circ.138.suppl_2.365 ◽

2018 ◽

Vol 138 (Suppl_2) ◽

Author(s):

Kazuhiro Sugiyama ◽

Kazuki Miyazaki ◽

Takuto Ishida ◽

Takahiro Tanabe ◽

Yuichi Hamabe

Keyword(s):

Computed Tomography ◽

Cardiac Arrest ◽

Coronary Angiography ◽

Hospital Discharge ◽

Left Ventricular ◽

Left Ventricular Wall ◽

Ventricular Wall ◽

Extracorporeal Cardiopulmonary Resuscitation ◽

Significant Stenosis ◽

Contrast Enhanced

Background: Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory cardiac arrest. Computed tomography (CT) is often performed after ECPR for diagnosis of etiology and evaluation of complications. However, few studies have reported left ventricular wall findings in contrast-enhanced CT (CE-CT) after ECPR. This study examined the left ventricular wall CE-CT findings after ECPR, and evaluated the association between these findings and the results of coronary angiography and prognosis. Method: We evaluated out-of-hospital cardiac arrest patients who were treated with ECPR and then underwent both non-ECG gated CE-CT and coronary angiography at our center between January 2011 and April 2018. The left ventricular wall CE-CT findings at 90 s after contrast injection were classified as follows: homogeneously-enhanced (HE), left ventricular wall was homogeneously enhanced; segmental defect (SD), left ventricular wall was not segmentally enhanced according to coronary artery territory; total defect (TD), entire left ventricular wall was not enhanced; and others. Significant stenosis on coronary angiography, survival to hospital discharge, and successful weaning from extracorporeal membrane oxygenation (ECMO) were examined. Results: A total of 111 patients were eligible. Median age was 59 years, and 85 (77%) had initial shockable rhythm. A total of 37 (33%) survived to hospital discharge. HE was observed in 33 patients, SD in 41, TD in 15, and others in 22. Among 74 patients who underwent CT prior to coronary angiography, SD predicted significant stenosis, with sensitivity of 83% and specificity of 100%. Among all patients, 28 (85%) with HE, 15 (37%) with SD, and 3 (20%) with TD were weaned successfully from ECMO. In addition, 17 (52%) patients with HE, 10 (24%) with SD, and 2 (13%) with TD survived to hospital discharge. Conclusion: SD could predict coronary artery stenosis with good specificity. Patients with HE had higher success rates for weaning from ECMO. On the other hand, TD was associated with poor outcomes. The left ventricular wall findings in non-ECG gated CE-CT after ECPR might be useful in diagnosis and prognostication.

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Data for comparison of computed tomography angiography and dynamic myocardial perfusion to detect significant stenosis by coronary angiography

Data in Brief ◽

10.1016/j.dib.2018.10.109 ◽

2018 ◽

Vol 21 ◽

pp. 953-955 ◽

Cited By ~ 1

Author(s):

Nobuo Tomizawa ◽

Shengpu Chou ◽

Yusuke Fujino ◽

Masaru Kamitani ◽

Kodai Yamamoto ◽

...

Keyword(s):

Computed Tomography ◽

Coronary Angiography ◽

Myocardial Perfusion ◽

Computed Tomography Angiography ◽

Significant Stenosis

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Significance of the caudal left-anterior-oblique view in analyzing the left main coronary artery and its major branches.

Radiology ◽

10.1148/radiology.139.1.7208939 ◽

1981 ◽

Vol 139 (1) ◽

pp. 39-43 ◽

Cited By ~ 7

Author(s):

L P Elliott ◽

P R Bream ◽

B Soto ◽

R O Russell ◽

W J Rogers ◽

...

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Left Main ◽

Oblique View ◽

Anterior Oblique View ◽

Left Anterior Oblique

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Coronary angiography Video of CAF. LAD was normal. The unusually dilated, tortuous, anomalous CAF is observed from the proximal LCX to the right. CAF, coronary artery fistula; LAD, left anterior descending artery; LCX, left circumflex artery.

ASVIDE ◽

10.21037/asvide.2021.235 ◽

2021 ◽

Vol 8 ◽

pp. 235-235

Author(s):

Liyuan Zhu ◽

Ling Liu

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Coronary Artery Fistula ◽

Circumflex Artery ◽

Left Circumflex Artery ◽

Left Anterior Descending Artery ◽

The Right

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Abstract 5803: Optimal Threshold for Multi Detector Computer Tomography to Detect Physiologically Significant Stenosis in Patients with Ischemic Heart Disease

Circulation ◽

10.1161/circ.118.suppl_18.s_106-a ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Takashi Yamano ◽

Atsushi Tanaka ◽

Takashi Tanimoto ◽

Shigeho Takarada ◽

Hiroki Kitabata ◽

...

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Coronary Angiography ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Optimal Threshold ◽

Fractional Flow ◽

Significant Stenosis ◽

Artery Disease

PURPOSE: Sixty-four multi detector computed tomography angiography (64-MDCT) has emerged as a rapidly developing method for the noninvasive detection of coronary artery disease with high negative predictive value and relatively low positive predictive value, especially in patients with intermediate-severity coronary artery disease (ISCAD). There are, however, few studies regarding with optimal threshold for detection of physiologically significant stenosis in 64-MDCT. The purpose of this study was to investigate the optimal threshold for 64-MDCT to detect physiologically significant stenosis using fractional flow reserve of the myocardium (FFRmyo) in patients with ISCAD. METHODS: We enrolled single lesions detected by 64-MDCT of 64 ISCAD patients (age, 68.3 +/− 10.2 years; 78% male). FFRmyo </= 0.75 measured by a 0.014-inch pressure wire was used as the gold standard for presence of physiologically significant stenosis. The area stenosis (%AS) in 64-MDCT were compared with the results of FFRmyo and percent diameter stenosis (%DS) in quantitative coronary angiography (QCA) during elective coronary angiography. Using receiver operating characteristic (ROC) analysis, the optimum threshold for percent area stenosis (%AS) in 64-MDCT was determined in the prediction of FFRmyo </= 0.75. RESULTS: There was an inverse correlation between %AS in 64-MDCT and FFRmyo (65 +/− 20 % and 0.71 +/− 0.16, respectively; r = −0.67; p < 0.01). Furthermore, there was a positive correlation between %AS in 64-MDCT and %DS in QCA (65 +/− 20 % and 63 +/− 19 %, respectively; r = 0.69; p < 0.01). Using a cutoff of 62 %AS in 64-MDCT, ROC curve analysis shows 79 % sensitivity, 85 % specificity, 82% positive predictive value, 83% negative predictive value and 83% accuracy for detecting physiologically significant stenosis. CONCLUSION: > 62 %AS in 64-MDCT could predict the physiologically significant coronary stenosis in patients with ISCAD. Applying an alternative threshold to detect physiologically significant stenosis might contribute to improve the diagnostic accuracy for 64-MDCT in patients with ISCAD.

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