Prevalence and characteristics of coronary artery anomalies using invasive coronary angiography in 6,237 consecutive patients in a single center in Turkey

2017 ◽  
Vol 08 (10) ◽  
Author(s):  
Kenan Erdem ◽  
Yilmaz Ozbay
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Invasive Coronary Angiography ◽  
Single Center ◽  
Coronary Artery Anomalies

Quantification of Coronary Artery Stenosis with 16-Slice MSCT in Patients before CABG Surgery: Comparison to Standard Invasive Coronary Angiography

2005 ◽  
Vol 8 (1) ◽  
pp. 42 ◽  
Author(s):  
C. Probst ◽  
A. Kovacs ◽  
C. Schmitz ◽  
W. Schiller ◽  
H. Schild ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Artery Bypass ◽  
Invasive Coronary Angiography ◽  
Bypass Graft ◽  
Heart Association ◽  
Artery Stenosis ◽  
Vessel Disease ◽  
Selective Coronary Angiography

Objective: Invasive, selective coronary angiography is the gold standard for evaluation of coronary artery disease (CAD) and degree of stenosis. The purpose of this study was to compare 3-dimensional (3D) reconstructed 16-slice multislice computed tomographic (MSCT) angiography and selective coronary angiography in patients before elective coronary artery bypass graft (CABG) procedure. Methods: Sixteen-slice MSCT scans (Philips Mx8000 IDT) were performed in 50 patients (42 male/8 female; mean age, 64.44 8.66 years) scheduled for elective CABG procedure. Scans were retrospectively electrocardiogram-gated 3D reconstructed. The images of the coronary arteries were evaluated for stenosis by 2 independent radiologists. The results were compared with the coronary angiography findings using the American Heart Association segmental classification for coronary arteries. Results: Four patients (8%) were excluded for technical reasons. Thirty-eight patients (82.6%) had 3-vessel disease, 4 (8.7 %) had 2-vessel disease, and 4 (8.7%) had an isolated left anterior descending artery stenosis. In the proximal segments all stenoses >50% (56/56) were detected by MSCT; medial segment sensitivity was 97% (73/75), specificity 90.3%; distal segment sensitivity was 90.7% (59/65), specificity 77%. Conclusion: Accurate quantification of coronary stenosis greater than 50% in the proximal and medial segments is possible with high sensitivity and specificity using the new generation of 16-slice MSCTs. There is still a tendency to overestimate stenosis in the distal segments. MSCT seems to be an excellent diagnostic tool for screening patients with possible CAD.

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.

scholarly journals Coronary Flow and Reserve by Enhanced Transthoracic Doppler Trumps Coronary Anatomy by Computed Tomography in Assessing Coronary Artery Stenosis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 245
Author(s):  
Carlo Caiati ◽  
Arnaldo Scardapane ◽  
Fortunato Iacovelli ◽  
Paolo Pollice ◽  
Teresa Immacolata Achille ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Flow Velocity ◽  
Coronary Flow ◽  
Invasive Coronary Angiography ◽  
Coronary Anatomy ◽  
Color Mapping ◽  
Flow Reserve ◽  
Mild Stenosis ◽  
Iodinated Contrast

We report the case of a 71-year-old patient with many risk factors for coronary atherosclerosis, who underwent computed coronary angiography (CTA), in accordance with the guidelines, for recent onset atypical chest pain. CTA revealed critical (>50% lumen diameter narrowing) stenosis of the proximal anterior descending coronary, and the patient was scheduled for invasive coronary angiography (ICA). Before ICA he underwent enhanced transthoracic echo-Doppler (E-Doppler TTE) for coronary flow detection by color-guided pulsed-wave Doppler recording of the left main (LMCA) and whole left anterior descending coronary artery (LAD,) along with coronary flow reserve (CFR) in the distal LAD calculated as the ratio, of peak flow velocity during i.v. adenosine (140 mcg/Kg/m) to resting flow velocity. E-Doppler TTE mapping revealed only mild stenosis (28% area narrowing) of the mid LAD and a CFR of 3.20, in perfect agreement with the color mapping showing no flow limiting stenosis in the LMCA and LAD. ICA revealed only a very mild stenosis in the mid LAD and mild atherosclerosis in the other coronaries (intimal irregularities). Thus, coronary stenosis was better predicted by E-Doppler TTE than by CTA. Coronary flow and reserve as assessed by E-Doppler TTE trumps coronary anatomy as assessed by CTA, without exposing the patient to harmful radiation and iodinated contrast medium.

scholarly journals Diagnostic and prognostic value of coronary artery calcium score of zero: is it time for guidelines to change?

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Arbas Redondo ◽  
D Tebar Marquez ◽  
I.D Poveda Pinedo ◽  
R Dalmau Gonzalez-Gallarza ◽  
S.C Valbuena Lopez ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Coronary Artery Calcium ◽  
Cardiac Ct ◽  
Invasive Coronary Angiography ◽  
Agatston Score ◽  
Non Invasive ◽  
Artery Disease

Abstract Introduction Cardiac computed tomography (CT) use has progressively increased as the preferred initial test to rule out coronary artery disease (CAD) when clinical likelihood is low. Coronary artery calcium (CAC) detected by CT is a well-established marker for cardiovascular risk. However, it is not recommended for diagnosis of obstructive CAD. Absence of CAC, defined as an Agatston score of zero, has been associated to good prognosis despite underestimation of non-calcified plaques. Purpose To evaluate whether zero CAC score could help ruling out obstructive CAD in a safely manner. Methods Observational study based on a prospective database of patients (pts) referred to cardiac CT between 2017 and 2019. Pts with an Agatston score of zero were selected. Results We included 176 pts with zero CAC score and non-invasive coronary angiography performed. The median duration of follow-up was 23.9 months. Baseline characteristics of the population are shown in Table 1. In 117 pts (66.5%), cardiac CT was indicated as part of their chest pain evaluation. Mean age was 57.2 years old, 68.2% were women and only and 9.4% were active smokers. Normal coronary arteries were found in 173 pts (98.3%). Obstructive CAD, defined as ≥50% luminal diameter stenosis of a major vessel, was present in 1/176 (0.6%); while non-obstructive atherosclerotic plaques were found in 2 pts (1.1%). During follow-up, one patient died of out-of-hospital cardiac arrest. None either suffered from myocardial infarction or needed coronary revascularization. Conclusions In our cohort, a zero CAC score detected by cardiac CT rules out obstructive coronary artery disease in 98.3%, with only 1.7% of non-calcified atherosclerosis plaques and 0.6% of major adverse events. Although further research on this topic is needed, these results support the fact that non-invasive coronary angiography could be avoided in patients with low clinical likelihood of CAD and zero CAC score, facilitating the management of the increasing demand for coronary CT and reduction of radiation dose. Funding Acknowledgement Type of funding source: None

scholarly journals Coronary artery anomalies in adults: Imaging at dual source CT coronary angiography

2012 ◽  
Vol 57 (2) ◽  
pp. 184-190 ◽  
Author(s):  
Fotios Laspas ◽  
Arkadios Roussakis ◽  
Christos Mourmouris ◽  
Nikolaos Kritikos ◽  
Roxani Efthimiadou ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Ct Coronary Angiography ◽  
Dual Source Ct ◽  
Coronary Artery Anomalies ◽  
Dual Source

scholarly journals A case report of a symptomatic right anomalous coronary artery with concomitant atherosclerotic disease: the benefit of a sequential comprehensive non-invasive and invasive diagnostic approach

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Marius Reto Bigler ◽  
Adrian Thomas Huber ◽  
Lorenz Räber ◽  
Christoph Gräni
Keyword(s):  
Computed Tomography ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Myocardial Ischaemia ◽  
Invasive Coronary Angiography ◽  
Atherosclerotic Disease ◽  
Diagnostic Approach ◽  
Anomalous Coronary Artery ◽  
Atherosclerotic Stenosis ◽  
Anomalous Coronary

Abstract Background  Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital disease associated with an increased risk of myocardial ischaemia, ventricular arrhythmias, and heart failure. Case summary  A 75-year-old Caucasian man was referred for invasive coronary angiography (ICA) due to atypical chest pain. Invasive coronary angiography demonstrated non-significant atherosclerotic disease of the left coronary artery and an anomalous origin of the right coronary artery (RCA); without selective intubation. Coronary computed tomography angiography (CCTA) revealed a right-AAOCA with interarterial and intramural course, and a soft plaque in the distal RCA. Subsequent physical-stress single-photon emissions computed tomography (SPECT) showed exercise-induced inferoapical myocardial ischaemia, giving a Class IC level of evidence for surgical correction of the AAOCA. Repeated ICA with selective R-AAOCA intubation confirmed an 80% distal atherosclerotic stenosis, which was treated with direct stenting. Subsequent invasive physiologic evaluation under maximal dobutamine-volume challenge (gradually increasing dose of dobutamine max. 40 μg/kg per body weight/min, 3000 mL ringer lactate and 1 mg atropine was given until the patient reached a maximum of 145 b.p.m.), revealed a haemodynamically non-relevant anomalous segment with a fractional flow reserve (FFR) of 0.91. A follow-up SPECT was normal, and the patient was completely symptom-free at 1 month. Discussion  We present the sequential diagnostic approach in a symptomatic patient with a right anomalous coronary artery and concomitant atherosclerotic disease. Using this approach, the patient could be deferred from guideline recommended open-heart surgery of the AAOCA, as direct invasive dobutamine/volume FFR revealed haemodynamic non-relevance of the anomalous segment after stenting the concomitant atherosclerotic stenosis in the distal segment within the same coronary artery.

scholarly journals Right Coronary Artery Originating from the Left: Do Not Miss the Diagnosis!

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Sedat Türkoğlu ◽  
Serkan Ünlü ◽  
Gülten Aydoğdu Taçoy ◽  
Murat Özdemir
Keyword(s):  
Coronary Artery ◽  
Coronary Angiography ◽  
Common Type ◽  
Coronary Anomaly ◽  
Single Center ◽  
Catheterization Laboratory ◽  
True Prevalence ◽  
Frequent Form ◽  
The Right ◽  
Coronary Angiograms

Objective. Left circumflex (LCx) artery originating from the right coronary arterial (RCA) system has been reported as the most common form of anomalous origination of a coronary artery from the opposite sinus (ACAOS). However, some studies claim that RCA originating from the left coronary sinus (LCS) is the most frequent form. The aim of this study was to determine the most common type of ACAOS in a single center.Materials and Methods. The database of the catheterization laboratory was retrospectively searched. All patients who were performed coronary angiography between 1999 and 2006 were included to registry. All examinations were carefully analyzed to determine the most frequent type of ACAOS.Results. We detected ACAOS in 35 cases (16 RCA originating from the LCS, 13 LCx from the RCS or the RCA, and 6 others) out of 5165 coronary angiograms. The most common form was RCA originating from LCS. Moreover, we revealed that 5 cases with RCA originating from the LCS were previously misdiagnosed and not reported as a coronary anomaly.Conclusions. RCA originating from the LCS was the most common form of ACAOS in our registry. The high change of misdiagnosis or underreporting of this anomaly could have biased the true prevalence.

scholarly journals CT Coronary Angiography versus Coronary Angiography to Detect Specificity and Sensitivity of CT Coronary

2019 ◽  
pp. 1-6
Author(s):  
Sheref M Zaghloul ◽  
Walid Hassan ◽  
Ashraf M Reda ◽  
Ghada M Sultan ◽  
Mohamed A Salah ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Present Report ◽  
Invasive Coronary Angiography ◽  
Ct Coronary Angiography ◽  
Point Of View ◽  
Stent Restenosis ◽  
Specificity And Sensitivity ◽  
Artery Disease

Background: Various diagnostic tests including conventional invasive coronary angiography and non-invasive Computed Tomography (CT) coronary angiography are used in the diagnosis of Coronary Artery Disease (CAD). Objective: The present report aims to evaluate the specificity and sensitivity of CT coronary angiography in diagnosis of coronary artery disease compared to the standard invasive coronary angiography. Methods: A retrospective study was done over 2 years started from May of 2015 up to May of 2017. The medical evaluation was based on systematic reviews of diagnostic studies with invasive coronary angiography and those with CT coronary angiogram. Data on special indications (bypass grafts, in-stent-restenosis) were also included in the evaluation. The CT scanners used with 320 slices. The study included patients with diabetes, hypertension, and data included age, glomerular filtration rate and ejection fraction. Results: Of the 99 patients included in the study, sensitivity of the total lesions were 87.1% which was highest for the graft lesions (100% sensitivity) and lowest for the Left Main (LM) lesions (83.3% sensitivity), on the other hand the specificity of the total lesion were high (98.1% specificity) which also was highest for the graft lesions (100% specificity) and lowest for the Left Anterior Descending (LAD) lesions (95% specificity). Regarding accuracy, CT coronary was 96.6% accurate for the whole lesions. Conclusions: From a medical point of view, CT coronary angiography using scanners with at least 320 slices should be recommended as a test to rule in obstructive coronary stenosis in order to avoid inappropriate invasive coronary angiography in patients with an intermediate pretest probability of CAD. Multi detector CT (MDCT) has reasonably high accuracy for detecting significant obstructive CAD when assessed at artery level.

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