Learning objectives
Utilize novel teaching tools to facilitate understanding of complex concepts.
Understand the hemodynamically significant coronary artery anomalies.
Translate theoretical patterns of disease to their radiologic correlates.
Background
Anomalous origins of the coronary arteries vary in their clinical significance. While the majority of cases are found incidentally, certain anomalies carry an increased risk for cardiac arrhythmias and sudden cardiac death. Cardiothoracic radiologists spend the majority of their practice interpreting these anomalies; however, resident radiologists may not spend a significant portion of their training on cardiac imaging. Radiologists tend to be visual learners. By incorporating the hands-on creation of models as teaching tools, residents are able to learn complex, unfamiliar pathology with greater efficiency....
Findings and procedure details
Classification of Anomalous Coronary Arteries:
Anomalies can be classified as hemodynamically or non-hemodynamically significant. The hemodynamically significant anomalies include coronary atresia, origin from the pulmonary artery, and interarterial course, or a congenital fistula. Non-hemodynamically insignificant variants include origin from a different coronary cusp, high or anomalous origin from the aorta, and a pre-pulmonic, transseptal, or retroaortic course. There have been documented cases of the coronary arteries arising from almost any vascular structure in the mediastinum. This presentation is limited to the most common anomalies arising...
Conclusion
There is a wide range of coronary artery anomalies. These abnormalities are rare and can be missed if the radiologist does not have sufficient knowledge of the possibilities. While most variants do not carry significant risk for sudden cardiac death, any anomaly of the coronary vessels can interfere with traditional surgical techniques, making surgery more complicated. Identification of these anomalies is critical for aiding cardiothoracic surgeons. Special attention to the coronary vessels is important for patients with cardiac symptoms, or for those who have significant...
Personal information and conflict of interest
C. Shilagani; Valhalla, NEW YORK/US - nothing to disclose P. Chiarolanzio; Valhalla/US - nothing to disclose P. Gerard; Valhalla, NY/US - nothing to disclose G. Pearson; Valhalla/US - nothing to disclose
References
Fujimoto S, et al. “Prevalence of anomalous origin of coronary artery detected by multi-detector computed tomography at one center.” J Cardiol 2011;57(1):69–76.
Frescura C, et al. “Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease.” Hum Pathol 1998;29(7):689–695.
Cademartiri F, et al. “Prevalence of anatomical variants and coronary anomalies in 543 consecutive patients studied with 64-slice CT coronary angiography.” Eur Radiol 2008;18(4): 781–791.
Möhlenkamp S, et al. “Update on myocardial bridging.” Circulation 2002;106(20):...