An Automatic Seeding Method For Coronary Artery Segmentation and Skeletonization in CTA

An automatic seeding method for coronary artery segmentation and skeletonization is presented. The new method includes automatic removal of the rib cage, tracing of the ascending aorta and initial planting of seeds for the coronary arteries. The automatic seeds are then passed on to a �virtual contrast injection� algorithm performing segmentation and skeletonization. In preliminary experiments, most main branches of the coronary tree were segmented and skeletonized without any user interaction.

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Unusual Intramural Coronary Artery With Vertical Course Complicating an Arterial Switch Operation

World Journal for Pediatric and Congenital Heart Surgery ◽

10.1177/2150135117723906 ◽

2017 ◽

Vol 10 (2) ◽

pp. 231-234

Author(s):

Lok Sinha ◽

Richard A. Jonas ◽

Pranava Sinha

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Arterial Switch Operation ◽

Ascending Aorta ◽

Sinus Of Valsalva ◽

Arterial Switch ◽

Switch Operation ◽

Technical Modifications ◽

Intramural Coronary Artery

Intramural coronary arteries in patients with d-transposition of the great arteries (d-TGA) usually arise from the opposite sinus of Valsalva and traverse horizontally across the posterior/facing commissure before emerging externally from the appropriate sinus of Valsalva. Failure to make appropriate technical modifications during coronary transfer can result in an important risk of posttransfer ischemia. We report a case with an unusual course of an intramural left anterior descending (LAD) coronary artery in a patient with d-TGA, with origin at the mid ascending aorta and a vertical intramural course, increasing the susceptibility to injury during an arterial switch operation (ASO).

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Endovascular Reconstruction from Aortic Valve to Aortic Arch Using One-Piece Valved-Fenestrated Stent Graft with a Branch: A Proof-of-Concept Study

The Heart Surgery Forum ◽

10.1532/hsf.2585 ◽

2019 ◽

Vol 22 (5) ◽

pp. E380-E384 ◽

Cited By ~ 2

Author(s):

Tao Li ◽

Xianhao Bao ◽

Jiaxuan Feng ◽

Zhenjiang Li ◽

Junjun Liu ◽

...

Keyword(s):

Coronary Artery ◽

Aortic Valve ◽

Aortic Arch ◽

Stent Graft ◽

Coronary Arteries ◽

Aortic Root ◽

Ascending Aorta ◽

Sinus Of Valsalva ◽

Fenestrated Stent Graft ◽

Transapical Access

Objective: To explore the feasibility of endovascular reconstruction of aortic root including aortic valve, sinus of valsalva and ascending aorta by a single stent-graft, a novel valved stent-graft with two fenestrae for preserving the coronary arteries was designed and performed in-vitro on a pig heart based circulation simulating system. Methods: Pig hearts were harvested from 30 healthy adult female pigs weighing between 60-65 kilograms. Before sacrifice, all the pigs received aortic computed tomography angiography (CTA) examinations and morphologic parameters of aortic root were measured. Then we customized the valved stent-grafts according to the CTA measurements. After the pig heart was fixed on the special platform according to the original orientation and connected to the circulation system, the stent graft was delivered through transapical access and covered the segment from aortic annulus to proximal part of aortic arch under DSA (digital subtraction angiography) guidance. Then changes of coronary flow before and after the procedure and fenestration alignment with coronary ostia were analyzed. Results: The overall technical success rate was 100%. The valve functions tested by ultrasound were in good condition under 120 mmHg circulation pressure. The flow of left coronary artery (LCA) did not decrease, but increased after the stent-graft implantation (340 ± 2.06 mL/min versus 288 ± 5.29 mL/min, P < .05). Similarly, the flow of right coronary artery (RCA) also increased (392 ± 9.17 mL/min versus 348 ± 8.01 mL/min; P < .05). The final angiography confirmed that both coronary arteries were patent. When generally observed from outer wall of valsalva sinus, both RCA and LCA orifices were aligned with the fenestrae. In 4 cases, the autologous valve leaflets blocked nearly 20% of the LCA fenestra’s area, but the flow did not significantly decrease in these cases. Conclusion: Stimulated on a pig heart-based circulation simulation system, the one-piece valved-fenestrated stent graft with a branch could be delivered via the transapical access and deployed accurately, which achieved endovascular reconstruction of aortic valve, sinus of valsalva and ascending aorta while preserving the coronary artery perfusion by fenestrations. More in-vivo experiments on animal models are mandatory to further verify its efficacy and safety.

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Anomalous origin of coronary arteries with an interarterial course: pictorial essay

Radiologia Brasileira ◽

10.1590/0100-3984.2017.0203 ◽

2019 ◽

Vol 52 (3) ◽

pp. 193-197

Author(s):

Ana Flávia Pina Ferreira ◽

Sharon Rosemberg ◽

Daniel Simões Oliveira ◽

José de Arimatéia Batista Araujo-Filho ◽

Cesar Higa Nomura

Keyword(s):

Coronary Artery ◽

Ct Angiography ◽

Coronary Arteries ◽

Pulmonary Valve ◽

Ascending Aorta ◽

Pulmonary Trunk ◽

Anomalous Origin ◽

Pictorial Essay ◽

High Resolution Images ◽

The Right

Abstract Coronary arteries originating from the contralateral (noncoronary) sinus and having an interarterial course, in which they run from the ascending aorta to the pulmonary trunk, is a potentially fatal anomaly. Computed tomography (CT) angiography facilitates the recognition and therapeutic planning of such anomalies because of its ability to acquire high-resolution images of the entire course of the coronary artery, as well as of the accompanying atherosclerotic involvement. The right coronary artery originating from the left coronary sinus is the most prevalent anomaly of this type and usually implies a better prognosis, the interarterial course being classified as "high" or "low", depending on whether it is above or below the level of the pulmonary valve, with consequent stratification of the risk and the treatment. However, it is known that there is a high risk of sudden death among patients with a left coronary artery of anomalous origin from the right sinus. In such cases, surgical treatment is recommended, regardless of whether there are symptoms or evidence of ischemia. Given the importance of those aspects, which can be identified on CT of the chest or CT angiography of the aorta, this pictorial essay aims to illustrate such anomalies to facilitate their recognition and description by radiologists who are not specialists in cardiac imaging.

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Arterial switch operation in non-facing coronary artery ostium

Asian Cardiovascular and Thoracic Annals ◽

10.1177/0218492319825966 ◽

2019 ◽

Vol 27 (6) ◽

pp. 492-494

Author(s):

Thaworn Subtaweesin

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Arterial Switch Operation ◽

Ascending Aorta ◽

Arterial Switch ◽

Switch Operation

The arterial switch operation was performed on a 38-day-old infant with d-transposition of the great arteries and abnormal origin of the left anterior descending and right coronary arteries from a non-facing sinus. A vertical aortic tube flap was established to lengthen the abnormally originating coronary arteries, by transecting part of the ascending aorta 2 cm above the coronary orifices. Both coronary arteries were transferred to the neoaortic root in a single extended tube.

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The peculiarities of atherosclerotic coronary arteries lesion in patients with coronary artery disease and type 2 diabetes mellitus

Endocrine Abstracts ◽

10.1530/endoabs.32.p423 ◽

2013 ◽

Author(s):

Larysa Zhuravlyova ◽

Nataliia Lopina ◽

Inna Demchenko

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Coronary Artery Disease ◽

Type 2 Diabetes Mellitus ◽

Coronary Artery ◽

Coronary Arteries ◽

Artery Disease

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

The Heart Surgery Forum ◽

10.1532/hsf98.20041144 ◽

2005 ◽

Vol 8 (1) ◽

pp. 42 ◽

Cited By ~ 12

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.

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An Epicardial Mesothelial Cyst Attached to the Ascending Aorta

The Heart Surgery Forum ◽

10.1532/hsf.1293 ◽

2015 ◽

Vol 18 (5) ◽

pp. 194

Author(s):

Yoshihito Suenaga ◽

Tomonobu Abe ◽

Masato Mutsuga ◽

Yoshimori Araki ◽

Akihiko Usu

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Surgery ◽

Bypass Surgery ◽

Artery Bypass ◽

Mesothelial Cell ◽

Rare Condition ◽

Ascending Aorta ◽

Mesothelial Cyst ◽

Great Vessels ◽

Insight Into

An epicardial mesothelial cyst, which can be defined as a mesothelial cyst attached to the epicardium surrounding the heart and the great vessels inside the pericardial sac, is a rare condition. We herein report a case of epicardial cyst, which was attached to the ascending aorta. The patient was a 76-year-old male who underwent coronary artery bypass surgery, and the cyst was found incidentally. It was approximately 5 cm in diameter, and histological examination confirmed mesothelial cell origin. The ascending aorta has not previously been reported as the origin of an epicardial mesothelial cyst. This case gives new insight into the embryology of these cysts

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Congenital Left Main Coronary Artery to Coronary Sinus Fistula

The Heart Surgery Forum ◽

10.1532/hsf98.20101085 ◽

2011 ◽

Vol 14 (4) ◽

pp. 255 ◽

Cited By ~ 4

Author(s):

Fotios A. Mitropoulos ◽

Meletios A. Kanakis ◽

Periklis A. Davlouros ◽

George Triantis

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Coronary Sinus ◽

Left Main Coronary Artery ◽

Coronary Artery Fistula ◽

Left Main ◽

Coronary Fistula ◽

Excellent Outcome ◽

Surgical Ligation ◽

Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

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