scholarly journals The prevalence and types of coronary artery abnormalities in pediatric patients with Tetralogy of Fallot

2021 ◽  
Author(s):  
Nima Mehdizadegan ◽  
Kholud Saeidi ◽  
Kambiz Keshavarz
Keyword(s):  
Coronary Artery ◽  
Tetralogy Of Fallot ◽  
Coronary Arteries ◽  
Heart Diseases ◽  
Common Finding ◽  
P Value ◽  
Coronary Anomalies ◽  
Coronary Artery Abnormalities ◽  
Operation Knowledge ◽  
Cyanotic Congenital Heart Diseases

Abstract Objectives: Tetralogy of fallot (TOF) is one of the most common diseases among cyanotic congenital heart diseases which is associated with 2-23% of coronary artery abnormalities. Pre-operation knowledge the anatomy of coronary arteries in patients with TOF eliminates damage to them during surgery and prevents post-operative complications such as myocardial ischemia and heart failure.Materials and methods:This retrospective study was done on all patients with TOF who were referred for diagnostic catheterization and angiography before total surgical correction from 2006-2016. All patients entered the study and all angiographic views including extreme caudal, LAO cranial , and selective coronary artery angiography were evaluated and reviewed accurately.Results: 332 cases of patients with TOF including from one month to 36 years old were reviewed. The prevalence of coronary artery abnormalities among them was 11.4% (38 from 322 individual). 9.1% and 15.3% of males and females had abnormal coronary anomalies but it was not significant statically (p-value: 0.064). In 13 of 38 patients with coronary anomalies , coronary arteries crossed right ventricular out flow tract (RVOT)(3.4%). The most common coronary abnormality was origin of the both main coronary arteries from left sinus of Valsalva.Conclusion:Compared with other populations, the abnormal arteries among the patients with TOF in our study is significant (11.4%) and accurate assessment of their courses is necessary before surgery. Single origin of coronary arteries from the left side was the most common finding in our study too.

Associated Coronary Anomalies in 135 Iranian Patients with Tetralogy of Fallot

2005 ◽  
Vol 13 (4) ◽  
pp. 307-310 ◽  
Author(s):  
Manouchehr Hekmat ◽  
Sima Rafieyian ◽  
Mahnoush Foroughi ◽  
Majidi Mohammad M Tehrani ◽  
Beheshti Mahmoud Monfared ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Tetralogy Of Fallot ◽  
Coronary Arteries ◽  
Right Coronary Artery ◽  
Primary Repair ◽  
Coronary Ostium ◽  
Coronary Anomalies ◽  
The Right ◽  
Single Coronary Ostium ◽  
Iranian Patients

Coronary artery anomalies are common among patients with tetralogy of Fallot. One hundred and thirty-five patients (80 males and 55 females) with tetralogy of Fallot who underwent repair between 1995 and 2002 were studied to determine the incidence of coronary anomalies in Iranian patients. Eight (5.9%) patients (4 males and 4 females) had a surgically relevant coronary artery anomaly: single coronary ostium in 5, origin of the left anterior descending artery from the right coronary artery in 2, and origin of the right coronary artery from the left coronary artery in 1. The surgical technique in 3 of these patients was repair of the ventricular septal defect with a transverse incision on the right ventricle, without damage to the coronary arteries. In another patient, an allograft aortic valve cylinder was inserted. In the other 4 patients with a single coronary ostium, placement of a limited transannular patch was adequate. Consideration of these anomalies during primary repair could decrease the risk of operation in such patients. However, it seems that the presence of anomalous coronary arteries does not affect incremental risk after surgical repair.

scholarly journals The role of MDCT in the assessment of cardiac and extra-cardiac vascular defects among Egyptian children with tetralogy of Fallot and its surgical implementation

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Ahmed Elshimy ◽  
Rasha Tolba Khattab ◽  
Hend Galal Eldeen Mohamed Ali Hassan
Keyword(s):  
Tetralogy Of Fallot ◽  
Heart Diseases ◽  
Preoperative Evaluation ◽  
Vena Cava ◽  
Predictive Values ◽  
Surgical Interventions ◽  
Vascular Abnormalities ◽  
Egyptian Children ◽  
Cardiac Lesions ◽  
Cyanotic Congenital Heart Diseases

Abstract Background Tetralogy of Fallot (TOF) is considered the most common form of cyanotic congenital heart diseases (CHD), accounting for about 10% of cases. It includes four main cardiac defects, in addition to various extra-cardiac anomalies. Aim This study aimed to evaluate cardiac and extra-cardiac vascular defects associated with TOF among Egyptian children, regarding frequency and types with assessment of multi-slice or multi-detector computed tomography (MDCT) role in their diagnosis. Definitely, full detection of these vascular anomalies has utmost importance when evaluating such patients particularly before surgical intervention. Methods This study included 60 pediatric patients diagnosed as TOF, who underwent MDCT examination in our institute during period of 6 months from (March to September 2020), to confirm their trans-thoracic echocardiography (TTE) findings and detect other vascular abnormalities which cannot be precisely detected with TTE before their surgical interventions. Results The incidence of different extra-cardiac vascular defects diagnosed by MDCT among our patients was 85% which was significantly higher than that detected by TTE (55%). Moreover, MDCT was superior to TTE assessment as regards its diagnostic accuracy (96.6% vs. 80%), sensitivity (98% vs. 76.9%), and specificity (88.9% vs. 85.7%), in addition to both positive and negative predictive values. The most common anomalies detected were affecting the pulmonary artery (80%), followed by aorto-pulmonary vessels (45%), then aortic artery (40%), coronary arteries (20%), and lastly vena cava connection (6.7%). Patients’ demographic characteristics and clinical presentations were also presented. Conclusion This study confirmed that many extra-cardiac vascular defects are commonly associating cardiac lesions in TOF and emphasizing the great value of MDCT in their diagnosis. Certainly, proper detection of these anomalies will help decision-making during preoperative evaluation, corrective interventions, and further management of these cases.

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).

Echocardiographic diagnosis of congenital coronary artery abnormalities in a continuous series of adolescent football players

2019 ◽  
Vol 26 (9) ◽  
pp. 988-994 ◽  
Author(s):  
Stephan Gerling ◽  
Oliver Loose ◽  
Robert Zant ◽  
Holger Michel ◽  
Michael Melter ◽  
...  
Keyword(s):  
Coronary Artery ◽  
High Risk ◽  
Coronary Arteries ◽  
Left Coronary Artery ◽  
Screening Tests ◽  
Continuous Series ◽  
Football Players ◽  
Coronary Artery Abnormalities ◽  
2D Echocardiography ◽  
The Usa

Background Sudden cardiac death (SCD) in children and adolescents is rare. Several studies have reported a higher risk of SCD during athletic competition. High risk congenital coronary artery abnormalities are the second leading cause of SCD in young athletes in the USA. Echocardiographic assessment of coronary arteries has not been routinely used in screening programmes for junior athletes so far. Design Prospective cohort study in 1045 consecutive adolescent elite football players. Methods All athletes underwent a standardized cardiovascular screening protocol with a medical history, a physical examination, 12-lead resting electrocardiogram and a complete transthoracic 2D-echocardiography. Results Two athletes (0.19%) showed a high-risk coronary artery abnormality (CAA) with a right coronary artery originating abnormal from the aorta and coursing inter-arterial. Low-risk CAAs were found in 16 athletes (1.53%). There was an ectasia of the left coronary artery (+3.9z and +4.3z) and a fistula from the left coronary artery in two cases (0.19%), respectively. In 1.05% ( n = 11) we found a high take-off (2.3–6.8 mm) and in one case (0.096%) there was a tangential take-off of the right main coronary artery. Variants of coronary arterial anatomy were identified in 335 of 1045 athletes (32.06%). Conclusion Basic pre-participation screening tests including 12-lead or exercise electrocardiogram do not safely identify high-risk CAAs. In adolescent athletes an expert cardiologist is able to describe the origin and the proximal course of the coronary arteries and identify major abnormalities in most of the cases by transthoracic 2D-echocardiography.

scholarly journals Epicardial adipose tissue volume is associated with low-attenuation plaque volume in subjects with or without increased visceral fat: a 3-vessel coronary artery analysis with CT angiography

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Otsuka ◽  
H Ishikawa ◽  
H Yamaura ◽  
K Shirasawa ◽  
N Kasayuki
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Arteries ◽  
Visceral Fat ◽  
Obstructive Coronary Artery Disease ◽  
Visceral Obesity ◽  
P Value ◽  
Plaque Volume ◽  
Artery Disease

Abstract Background Low-attenuation plaque (LAP) with a CT value of less than or equal 30 HU on coronary CT angiography (CCTA) is a marker of high-risk plaque features that leads to future acute coronary syndromes. Perivascular and epicardial adipose tissue (EAT) have been shown to be associated with progression of high-risk coronary plaques through metabolic and inflammatory mechanisms. However, association of EAT with LAP volume in three coronary arteries in subjects with or without visceral obesity remain unclear. Aims This study aimed to investigate the association of EAT volume (EAV) and coronary 3-vessel LAP volume in subjects with or without visceral obesity who underwent CCTA. Methods Patients who underwent CCTA without known coronary artery disease were included in the study (525 patients). Study subjects were classified as having non-obstructive or obstructive coronary artery disease according to the degree of coronary artery stenosis on CCTA. The plaque volume and EAV of the main vessel of the left anterior descending artery, left circumflex artery, and right coronary artery were measured with VINCENT software. Coronary plaque composition was classified as calcified plaque (CP, >150HU), noncalcified plaque (NCP, 30–150HU), and Lap (<30HU). The %LAP volume of the three coronary arteries was classified into quartiles. Multiple logistic regression analysis was used to analyze the factors associated with the %LAP volume. Results Compared with subjects without increase visceral fat, subjects with increased visceral fat had a significantly higher BMI, a greater total plaque volume, a greater total %LAP volume, a greater EAV, and a lower mean CT value of EAT. A significant correlation was observed between EAV and %LAP volume (R=0.24, p<0.001). EAV (odds ratio; 1.83, 95% confidence interval 1.071–3.141, p-value 0.027) and type 2 diabetes mellitus (odds ratio 1.76, 95%confidence interval 1.042–3.000, p-value 0.034) appeared to be independent predictors of %LAP volume (Q4), when adjusted by age, gender, BMI>25 kg/m2, visceral fat >100cm2, LogCRP, coronary artery calcium score>300, and obstructive coronary artery disease requiring revascularization. Conclusion This study suggests that LAP volume, which reflects the high-risk plaques in the three coronary arteries, is associated with EAV in subjects with or without increased visceral fat. Further research is needed whether pharmacological therapeutic intervention enables the prevention of coronary plaque progression and destabilization through the reduction of EAV in patients. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals The Dominance Pattern of Coronary Artery of Adult Bangladeshi People- A Postmortem Morphological Study

1970 ◽  
Vol 1 (1) ◽  
pp. 21-25
Author(s):  
MA Hussain ◽  
A Nahar ◽  
S Ara
Keyword(s):  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Arteries ◽  
Heart Diseases ◽  
Age Groups ◽  
B 41 ◽  
Group A ◽  
Proper Diagnosis ◽  
Group B ◽  
Dominance Pattern

Background: Incidence of the heart disease increases day by day in Bangladesh. Recent advances in cardiac surgery and the search for new techniques toward investigation of the heart are demanding a review of the anatomy of the coronary arteries. Method: The present study was performed on sixty (60) adult postmortem human hearts of Bangladeshi people. The samples were divided into 3 age groups: Group A (20 to 40 years) consists of 35 male & 7 female samples, Group B (41 to 60 years) consists of 3 female samples and Group C (61 to 75 years) consists of 7 male samples. Results: In the present study, dominance pattern of the coronary artery was right for male in-group A, B, C were 32 (91.4%), 7(87.5%), 6(85.7%), respectively and for female were 6 (85.7%). 3 (100%) respectively. It was left for male in-group A, B, C were 3 (8.6%), 1 (12.5%), 1(14.3%), respectively and for female was 1 (14.3%). Conclusion: The results of the present study can be helpful to the cardiologists and cardiovascular surgeons in the proper diagnosis and management of the heart diseases. Key words : Postmortem heart, Coronary arteries, Ischaemic heart disease.   DOI: http://dx.doi.org/10.3329/cardio.v1i1.8200 Cardiovasc. j. 2008; 1(1) : 21-25  

Recent Innovations in Coronary Stents

2017 ◽  
pp. 233-244
Author(s):  
Poulomi Sengupta
Keyword(s):  
Blood Pressure ◽  
Coronary Artery ◽  
Old Age ◽  
Coronary Arteries ◽  
Heart Attack ◽  
Heart Diseases ◽  
Free Flow ◽  
Plaque Deposition ◽  
Brain Stroke ◽  
Fatty Plaque

In heart diseases, there are frequent incidents of narrowing or blocking coronary arteries by fatty plaque deposition. As a result, blood pressure rises and the arteries weaken. This can lead to rapid rupture of the blood vessels, also known as heart attack or brain stroke. In some cases the arteries lose elasticity over old age. Heart stent or coronary stent inserts in the blocked/fragile region of coronary artery. It helps to expand the artery to allow free flow of blood and consequently, reduces blood pressure. Over past 20 years there are many modifications and innovations in the field of cardiac stents, in this chapter we will discuss few of those.

Corridor technique for coronary arteries from a single arterial sinus

2020 ◽  
Vol 28 (6) ◽  
pp. 333-335
Author(s):  
Kota Agematsu ◽  
Mitsugi Nagashima ◽  
Yoshiharu Nishimura ◽  
Takashi Higaki
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Arterial Switch Operation ◽  
Early Mortality ◽  
Single Coronary Artery ◽  
Coronary Anomalies ◽  
Arterial Switch ◽  
Switch Operation ◽  
Late Morbidity ◽  
Independent Risk Factors

The introduction of the arterial switch operation has improved the surgical outcome of transposition of the great arteries. However, coronary anomalies such as intramural coronary arteries, single coronary artery, or coronary arteries originating from a single arterial sinus have been reported as independent risk factors for early mortality and late morbidity after an arterial switch operation. We performed an arterial switch operation using a unique technique for translocation of the coronary arteries originating from a single left-side arterial sinus, to prevent coronary artery distortion and subsequent coronary malperfusion.

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