Application of multidetector computer angiography for the diagnosis of coronary artery anomalies and rare variants of normal anatomy in cardiac surgery clinic.

Congress:

ESCR 2014

Poster Number:

477

Type:

Scientific Poster

Keywords:

Cardiac, Arteries / Aorta, Cardiovascular system, CT-Angiography, CT-High Resolution, Contrast agent-intravenous, Computer Applications-3D, CAD, Developmental disease, Congenital, Fistula

Authors:

I. Rychina, V. Makarenko, M. Shlyappo; Moscow/RU

DOI:

DOI-Link:

https://dx.doi.org/

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Purpose

Anomalies of the coronary arteries (ACA) is a rarely found category of malformations of the heart, covering a wide range of options for abnormal anatomy of coronary vessels. The presence of some morphological features of coronary arteries associated with the risk of sudden cardiac death, adverse effects on myocardial perfusion under increased workload as well as with the risk of various related complications lead to a need for cardiac surgery and endovascular interventions. Purpose: to present the universal standard systematic approach for defining ACA and...

Methods and Materials

The study included 2465 patients with MDCT angiography of the heart and coronary arteries (CA) (1479 men (60%) and 986 women (35%)). The mean age was 45+27 years. Computer Tomography was performed using CT scanner «SOMATOM Definition AS+» (128-slice) and iCT scanner Philips «Brilliance» (256-slice) with a slice thickness of 0.6 mm and retrospective ECG-synchronization. Post processing included MPR, 3D and 4D reconstruction using workstation «Leonardо», «Extended Brilliance Workspace». For analyzing the images of CA we used a universal standardized systematic approach. Consistently, we identified...

Results

Anomalies of the coronary arteries were detected in 14 patients (0.6 %). In 7 of them (50 %), we identified coronary heart fistula, in two patients (14.3 %) ALCAPA and in one patient (7.2 %) vertical ectopia origin of RCA; in one patient (7.2 %) the left main coronary artery departed from the right coronary aortic sinus and followed interarterially, and in one patient (7.2 %) the RCA departed from the LAD and followed prepulmonarily. Furthermore, in one patient (7.2 %) the RCA departed from...

Conclusion

MDCT-angiography of the heart and CA represents a highly informative method of diagnosis, identification and characterization of rare atypical variants of normal anatomy CA. Using the standardized systematic approach in the analysis of images obtained by MDCT-angiography can effectively differentiate between different forms of a wide range of normal and abnormal anatomy of the CA, which is of particular importance for the patient’s cardiac surgery profile.