Anomalous coronary arteries. An evaluation with CT-multidetector.

Abstract

Objectives: The aim of this study is to demonstrate that TC multidetector is a good method for assessment of coronary artery anomalies, allowing a tridimensional view, identifying their anomalous origin and anatomic course in relation to great vessels, it represents a very useful tool for cardiologists, hemodynamists or cardiac surgeons in the planning of an interventional procedure.
Methods: One hundred and eighty studies about coronary 16-CT multidetector published from November 1, 2002 to April 30, 2006 were retrospectively reviewed. The coronary arteries origin and course and the ostium shape were evaluated.
Results: Twenty six (2.2%) patients with anatomic abnormalities of the coronary arteries were found, 14 males and 12 females, the mean age was 60 years and 23 (88.46%) of these patients were referred for assessment of thoracic pain or suspicion of an acute coronary event. The anatomic abnormalities found in coronary arteries were: left trunk absence, (4); two right coronary arteries with an individual ostium each, (1); a circumflex artery originating from the right sinus, (2) and retrocardiac trajectory, (1); duplication of vessels, (6); anterior origin of the right coronary artery, (1); a right coronary artery originating from the left sinus of Valsalva and interarterial trajectory, (4); intramyocardial bridge, (3); retroaortic exit from the circumflex artery, (1); exit of the three vessels from the right coronary sinus, (1); a high right coronary artery ostium, (1); an arteriovenous fistula, (1); and a mammary artery branch from the first diagonal artery, (1).
Conclusions: The 16-CT multidetector offers a clear visualization of the origin and course of the anomalous coronary arteries with a tridimensional anatomic view not achieved by conventional angiography, especially for assessing their relationship with the great vessels.