Prevalence and characteristics of dual left anterior descending artery in adult patients undergoing coronary angiography

2019 ◽  
Vol 15 (6) ◽  
pp. 425-435
Author(s):  
Navdeep Singh Sidhu ◽  
Gagandeep Singh Wander
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Proximal Part ◽  
Adult Patients ◽  
Type I ◽  
Type Ii ◽  
Significant Stenosis ◽  
Left Anterior Descending Artery ◽  
Artery Disease

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.

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

Circulation ◽  
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.

scholarly journals Does Myocardial Bridge Appear More Frequently and Diffusely on Radial Access Coronary Angiography?

2021 ◽  
Author(s):  
oktay senoz ◽  
zeynep yapan emren
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Clinical Laboratory ◽  
Conventional Coronary Angiography ◽  
Myocardial Bridge ◽  
Radial Access ◽  
Left Anterior Descending Artery ◽  
Artery Disease

Abstract Background: Although the incidence of myocardial bridge (MB) has been defined in different conventional coronary angiography (CCA) studies,the frequency of MB in radial access coronary angiography (RACA) is unknown.The aim of this study was to determine the incidence of MB in patients undergoing RACA.Method: A total of 2600 consecutive patients who underwent RACA were retrospectively investigated to detect the presence of MB.The clinical,laboratory, and angiographic features of the patients with MB were analyzed. Results: MB was detected at an incidence of 10.2%, in 255/2600 patients who underwent RACA.The most involved coronary artery was the left anterior descending artery (LAD) (86.9%) and the mid segment (84.9%) was the most affected section.Co-involvement of multiple coronary arteries by MB was 7.8%. Coronary artery disease (CAD) was determined in 102 (36.2%) of the coronary arteries with MB, 82.4% which were proximal to the MB.Conclusion: These data demonstrated that the incidence of MB able to be detected on RACA was much higher than reported in previous CCA studies.

Coronary Artery Disease Screening Using CT Coronary Angiography

2020 ◽  
Vol 91 (10) ◽  
pp. 812-817
Author(s):  
Randy Wang Long Cheong ◽  
Brian See ◽  
Benjamin Boon Chuan Tan ◽  
Choong Hou Koh
Keyword(s):  
Systematic Review ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Cardiac Risk ◽  
Disease Screening ◽  
Ct Coronary Angiography ◽  
Major Adverse Cardiovascular Events ◽  
Cardiac Events ◽  
Artery Disease

BACKGROUND: The increased utility of CT coronary angiography (CTCA) in cardiovascular screenings of aircrew has led to the increased detection of asymptomatic coronary artery disease (CAD). A systematic review of studies relevant to the interpretation of CTCA for the occupational fitness assessment of high-risk vocations was performed, with findings used to describe the development of a pathway for the aeromedical disposition of military aviators with asymptomatic CAD.METHODS: Medline was searched using the terms CT coronary angiogram and screening and prognosis. The inclusion criteria were restricted to study populations ages > 18 yr, were asymptomatic, were not known to have CAD, had undergone CTCA, and with their associations with major adverse cardiovascular events (MACE) and other relevant cardiac outcomes reported.RESULTS: Included in this systematic review were 10 studies. When compared to subjects with no or nonobstructive CAD, those with obstructive CAD on CTCA had hazard ratios (HR) for cardiac events ranging from 1.42 to 105.48. Comparing subjects with nonobstructive CAD and those without CAD on CTCA, a lower HR of 1.19 for cardiac events was found. The annual event rates of subjects with no CAD on CTCA were extremely low, ranging from 0 to 0.5%.CONCLUSIONS: Based on the findings, we suggest that CTCA should only be performed in aircrew with higher cardiac risk profiles. Those found to have no CAD or minimal CAD (i.e., 25% stenosis) in a non-left main coronary artery on CTCA can be returned to flying duties. All other results should be further evaluated with an invasive angiogram.Cheong RWL, See B, Tan BBC, Koh CH. Coronary artery disease screening using CT coronary angiography. Aerosp Med Hum Perform. 2020; 91(10):812817.

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