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Imaging of Coronary Artery Anomalies

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Interventional Cardiology Imaging

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Abstract

Although coronary anomalies are recognized as the second leading cause of sudden death amongst young and seemingly healthy persons, they constitute a diverse group of uncommon and poorly understood cardiac disorders. Despite widely known implications of sudden cardiac death occurring from malignant forms of coronary anomalies within the medical community as well as among the general public, the pathophysiologic mechanisms that characterize the clinical presentations, long-term clinical repercussions and prognoses coronary anomalies are not well-defined. Imaging remains a cornerstone in the diagnosis and prognostication of these disorders. However, the optimal screening tool for these conditions remains elusive. Larger, longer-term data are needed to understand these entities with further clarity.

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References

  1. Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115:1296–305.

    PubMed  Google Scholar 

  2. Maron BJ, Shirani J, Poliac LC, Mathenge R, Roberts WC, Mueller FO. Sudden death in young competitive athletes. Clinical, demographic, and pathological profiles. JAMA. 1996;276:199–204.

    Article  CAS  PubMed  Google Scholar 

  3. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, del Nido P, Fasules JW, Graham Jr TP, Hijazi ZM, Hunt SA, King ME, Landzberg MJ, Miner PD, Radford MJ, Walsh EP, Webb GD. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118:e714–833.

    Article  PubMed  Google Scholar 

  4. Becker AE, Anderson RH. Coronary artery anomalies. In: Pathology of congenital heart disease. London: Butterworths; 1981.

    Google Scholar 

  5. Pursnani A, Jacobs JE, Saremi F, Levisman J, Makaryus AN, Capunay C, Rogers IS, Wald C, Azmoon S, Stathopoulos IA, Srichai MB. Coronary CTA assessment of coronary anomalies. J Cardiovasc Comput Tomogr. 2012;6:48–59.

    Article  PubMed  Google Scholar 

  6. Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation. 2002;105:2449–54.

    Article  PubMed  Google Scholar 

  7. Angelini P. Coronary artery anomalies–current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines. Tex Heart Inst J. 2002;29:271–8.

    PubMed Central  PubMed  Google Scholar 

  8. Zeina AR, Blinder J, Sharif D, Rosenschein U, Barmeir E. Congenital coronary artery anomalies in adults: non-invasive assessment with multidetector CT. Br J Radiol. 2009;82:254–61.

    Article  CAS  PubMed  Google Scholar 

  9. Wu B, Zhang Z, Lui W, Chen X, Wang Y, Chamberlain AA, Moreno-Rodriguez RA, Markwald RR, O’Rourke BP, Sharp DJ, Zheng D, Lenz J, Baldwin HS, Chang CP, Zhou B. Endocardial cells form the coronary arteries by angiogenesis through myocardial-endocardial VEGF signaling. Cell. 2012;151:1083–96.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Lluri G, Aboulhosn J. Coronary arterial development: a review of normal and congenitally anomalous patterns. Clin Cardiol. 2014;37:126–30.

    Article  PubMed  Google Scholar 

  11. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990;21:28–40.

    Article  CAS  PubMed  Google Scholar 

  12. Zhang LJ, Yang GF, Huang W, Zhou CS, Chen P, Lu GM. Incidence of anomalous origin of coronary artery in 1879 Chinese adults on dual-source CT angiography. Neth Heart J. 2010;18:466–70.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Manghat NE, Morgan-Hughes GJ, Marshall AJ, Roobottom CA. Multidetector row computed tomography: imaging congenital coronary artery anomalies in adults. Heart. 2005;91:1515–22.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  14. Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol. 1992;20:640–7.

    Article  CAS  PubMed  Google Scholar 

  15. Opolski MP, Pregowski J, Kruk M, Witkowski A, Kwiecinska S, Lubienska E, Demkow M, Hryniewiecki T, Michalek P, Ruzyllo W, Kepka C. Prevalence and characteristics of coronary anomalies originating from the opposite sinus of Valsalva in 8,522 patients referred for coronary computed tomography angiography. Am J Cardiol. 2013;111:1361–7.

    Article  PubMed  Google Scholar 

  16. Kaku B, Shimizu M, Yoshio H, Ino H, Mizuno S, Kanaya H, Ishise S, Mabuchi H. Clinical features of prognosis of Japanese patients with anomalous origin of the coronary artery. Jpn Circ J. 1996;60:731–41.

    Article  CAS  PubMed  Google Scholar 

  17. Wesselhoeft H, Fawcett JS, Johnson AL. Anomalous origin of the left coronary artery from the pulmonary trunk. Its clinical spectrum, pathology, and pathophysiology, based on a review of 140 cases with seven further cases. Circulation. 1968;38:403–25.

    Article  CAS  PubMed  Google Scholar 

  18. Mohlenkamp S, Hort W, Ge J, Erbel R. Update on myocardial bridging. Circulation. 2002;106:2616–22.

    Article  PubMed  Google Scholar 

  19. Shivalkar B, Borgers M, Daenen W, Gewillig M, Flameng W. ALCAPA syndrome: an example of chronic myocardial hypoperfusion? J Am Coll Cardiol. 1994;23:772–8.

    Article  CAS  PubMed  Google Scholar 

  20. Eckart RE, Scoville SL, Campbell CL, Shry EA, Stajduhar KC, Potter RN, Pearse LA, Virmani R. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004;141:829–34.

    Article  PubMed  Google Scholar 

  21. Lee H, et al. Anomalous origin of the right coronary artery from the left coronary sinus: subtypes and clinical importance. Radiology. 2012;262:101–8.

    Article  PubMed  Google Scholar 

  22. Cox ID, Bunce N, Fluck DS. Failed sudden cardiac death in a patient with an anomalous origin of the right coronary artery. Circulation. 2000;102:1461–2.

    Article  CAS  PubMed  Google Scholar 

  23. Roberts WC, Shirani J. The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). Am J Cardiol. 1992;70:119–21.

    Article  CAS  PubMed  Google Scholar 

  24. Frescura C, Basso C, Thiene G, Corrado D, Pennelli T, Angelini A, Daliento L. Anomalous origin of coronary arteries and risk of sudden death: a study based on an autopsy population of congenital heart disease. Hum Pathol. 1998;29:689–95.

    Article  CAS  PubMed  Google Scholar 

  25. Angelini P, Velasco JA, Ott D, Khoshnevis GR. Anomalous coronary artery arising from the opposite sinus: descriptive features and pathophysiologic mechanisms, as documented by intravascular ultrasonography. J Invasive Cardiol. 2003;15:507–14.

    PubMed  Google Scholar 

  26. Angelini P, Walmsley RP, Libreros A, Ott DA. Symptomatic anomalous origination of the left coronary artery from the opposite sinus of valsalva. Clinical presentations, diagnosis, and surgical repair. Tex Heart Inst J. 2006;33:171–9.

    PubMed Central  PubMed  Google Scholar 

  27. Saeed M, Gabara R, Strasberg B, Kusniec J, Rosanio S, Ware DL, Birnbaum Y. Reperfusion-related polymorphic ventricular tachycardia as a possible mechanism of sudden death in patients with anomalous coronary arteries. Am J Med Sci. 2005;329:327–9.

    Article  PubMed  Google Scholar 

  28. Warnes CA, Williams RG, Bashore TM, Child JS, Connolly HM, Dearani JA, del Nido P, Fasules JW, Graham Jr TP, Hijazi ZM, Hunt SA, King ME, Landzberg MJ, Miner PD, Radford MJ, Walsh EP, Webb GD, Smith Jr SC, Jacobs AK, Adams CD, Anderson JL, Antman EM, Buller CE, Creager MA, Ettinger SM, Halperin JL, Krumholz HM, Kushner FG, Lytle BW, Nishimura RA, Page RL, Riegel B, Tarkington LG, Yancy CW. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines (Writing Committee to develop guidelines on the management of adults with congenital heart disease). Developed in collaboration with the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:e143–263.

    Article  PubMed  Google Scholar 

  29. Frommelt PC, Frommelt MA, Tweddell JS, Jaquiss RD. Prospective echocardiographic diagnosis and surgical repair of anomalous origin of a coronary artery from the opposite sinus with an interarterial course. J Am Coll Cardiol. 2003;42:148–54.

    Article  PubMed  Google Scholar 

  30. Gaither NS, Rogan KM, Stajduhar K, Banks AK, Hull RW, Whitsitt T, Vernalis MN. Anomalous origin and course of coronary arteries in adults: identification and improved imaging utilizing transesophageal echocardiography. Am Heart J. 1991;122:69–75.

    Article  CAS  PubMed  Google Scholar 

  31. Davis JA, Cecchin F, Jones TK, Portman MA. Major coronary artery anomalies in a pediatric population: incidence and clinical importance. J Am Coll Cardiol. 2001;37:593–7.

    Article  CAS  PubMed  Google Scholar 

  32. Yang YL, Nanda NC, Wang XF, Xie MX, Lu Q, He L, Lu XF. Echocardiographic diagnosis of anomalous origin of the left coronary artery from the pulmonary artery. Echocardiography. 2007;24:405–11.

    Article  PubMed  Google Scholar 

  33. Angelini P, Flamm SD. Newer concepts for imaging anomalous aortic origin of the coronary arteries in adults. Catheter Cardiovasc Interv. 2007;69:942–54.

    Article  PubMed  Google Scholar 

  34. Kim SY, Seo JB, Do KH, Heo JN, Lee JS, Song JW, Choe YH, Kim TH, Yong HS, Choi SI, Song KS, Lim TH. Coronary artery anomalies: classification and ECG-gated multi-detector row CT findings with angiographic correlation. Radiographics. 2006;26:317–33; discussion 333–4.

    Article  PubMed  Google Scholar 

  35. Bluemke DA, Achenbach S, Budoff M, Gerber TC, Gersh B, Hillis LD, Hundley WG, Manning WJ, Printz BF, Stuber M, Woodard PK. Noninvasive coronary artery imaging: magnetic resonance angiography and multidetector computed tomography angiography: a scientific statement from the american heart association committee on cardiovascular imaging and intervention of the council on cardiovascular radiology and intervention, and the councils on clinical cardiology and cardiovascular disease in the young. Circulation. 2008;118:586–606.

    Article  PubMed  Google Scholar 

  36. Deshpande VS, Shea SM, Laub G, Simonetti OP, Finn JP, Li D. 3D magnetization-prepared true-FISP: a new technique for imaging coronary arteries. Magn Reson Med. 2001;46:494–502.

    Article  CAS  PubMed  Google Scholar 

  37. Weiger M, Pruessmann KP, Boesiger P. Cardiac real-time imaging using SENSE. SENSitivity Encoding scheme. Magn Reson Med. 2000;43:177–84.

    Article  CAS  PubMed  Google Scholar 

  38. Yang Q, Li K, Liu X, Du X, Bi X, Huang F, Jerecic R, Liu Z, An J, Xu D, Zheng H, Fan Z, Li D. 3.0T whole-heart coronary magnetic resonance angiography performed with 32-channel cardiac coils: a single-center experience. Circ Cardiovasc Imaging. 2012;5:573–9.

    Article  PubMed Central  PubMed  Google Scholar 

  39. McConnell MV, Ganz P, Selwyn AP, Li W, Edelman RR, Manning WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation. 1995;92:3158–62.

    Article  CAS  PubMed  Google Scholar 

  40. Post JC, van Rossum AC, Bronzwaer JG, de Cock CC, Hofman MB, Valk J, Visser CA. Magnetic resonance angiography of anomalous coronary arteries. A new gold standard for delineating the proximal course? Circulation. 1995;92:3163–71.

    Article  CAS  PubMed  Google Scholar 

  41. Taylor AM, Thorne SA, Rubens MB, Jhooti P, Keegan J, Gatehouse PD, Wiesmann F, Grothues F, Somerville J, Pennell DJ. Coronary artery imaging in grown up congenital heart disease: complementary role of magnetic resonance and x-ray coronary angiography. Circulation. 2000;101:1670–8.

    Article  CAS  PubMed  Google Scholar 

  42. Chinnaiyan KM, McCullough PA. Optimizing outcomes in coronary CT imaging. Rev Cardiovasc Med. 2008;9:215–24.

    PubMed  Google Scholar 

  43. Schmitt R, Froehner S, Brunn J, Wagner M, Brunner H, Cherevatyy O, Gietzen F, Christopoulos G, Kerber S, Fellner F. Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography. Eur Radiol. 2005;15:1110–21.

    Article  PubMed  Google Scholar 

  44. Shi H, Aschoff AJ, Brambs HJ, Hoffmann MH. Multislice CT imaging of anomalous coronary arteries. Eur Radiol. 2004;14:2172–81.

    Article  PubMed  Google Scholar 

  45. Andreini D, Mushtaq S, Pontone G, Cortinovis S, Annoni A, Formenti A, Agostoni P, Bartorelli AL, Fiorentini C, Ballerini G, Pepi M. Additional clinical role of 64-slice multidetector computed tomography in the evaluation of coronary artery variants and anomalies. Int J Cardiol. 2010;145:388–90.

    Article  PubMed  Google Scholar 

  46. Erol C, Seker M. Coronary artery anomalies: the prevalence of origination, course, and termination anomalies of coronary arteries detected by 64-detector computed tomography coronary angiography. J Comput Assist Tomogr. 2011;35:618–24.

    Article  PubMed  Google Scholar 

  47. Kim PJ, Hur G, Kim SY, Namgung J, Hong SW, Kim YH, Lee WR. Frequency of myocardial bridges and dynamic compression of epicardial coronary arteries: a comparison between computed tomography and invasive coronary angiography. Circulation. 2009;119:1408–16.

    Article  PubMed  Google Scholar 

  48. Taylor AJ, Cerqueira M, Hodgson JM, Mark D, Min J, O’Gara P, Rubin GD, Kramer CM, Berman D, Brown A, Chaudhry FA, Cury RC, Desai MY, Einstein AJ, Gomes AS, Harrington R, Hoffmann U, Khare R, Lesser J, McGann C, Rosenberg A, Schwartz R, Shelton M, Smetana GW, Smith Jr SC, Wolk MJ, Allen JM, Bailey S, Douglas PS, Hendel RC, Patel MR, Shaw L, Stainback RF. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 appropriate Use criteria for cardiac computed tomography. J Cardiovasc Comput Tomogr. 2010;4:407 e1–33.

    Article  Google Scholar 

  49. Maron BJ, Zipes DP. Introduction: eligibility recommendations for competitive athletes with cardiovascular abnormalities-general considerations. J Am Coll Cardiol. 2005;45:1318–21.

    Article  PubMed  Google Scholar 

  50. Reul RM, Cooley DA, Hallman GL, Reul GJ. Surgical treatment of coronary artery anomalies: report of a 37 1/2-year experience at the Texas Heart Institute. Tex Heart Inst J. 2002;29:299–307.

    PubMed Central  PubMed  Google Scholar 

  51. Jujjavarapu KR, Salhiyyah K, Witzke H, Amrani M. Off-pump total arterial revascularization for anomalous origin of the left coronary artery from the pulmonary artery. Ann Thorac Surg. 2013;96:2234–6.

    Article  PubMed  Google Scholar 

  52. Kudumula V, Mehta C, Stumper O, Desai T, Chikermane A, Miller P, Dhillon R, Jones TJ, De Giovanni J, Brawn WJ, Barron DJ. Twenty-year outcome of anomalous origin of left coronary artery from pulmonary artery: management of mitral regurgitation. Ann Thorac Surg. 2014;97(3):938–44.

    Google Scholar 

  53. Romp RL, Herlong JR, Landolfo CK, Sanders SP, Miller CE, Ungerleider RM, Jaggers J. Outcome of unroofing procedure for repair of anomalous aortic origin of left or right coronary artery. Ann Thorac Surg. 2003;76:589–95; discussion 595–6.

    Article  PubMed  Google Scholar 

  54. Krasuski RA, Magyar D, Hart S, Kalahasti V, Lorber R, Hobbs R, Pettersson G, Blackstone E. Long-term outcome and impact of surgery on adults with coronary arteries originating from the opposite coronary cusp. Circulation. 2011;123:154–62.

    Article  PubMed  Google Scholar 

  55. Maron BJ. Hypertrophic cardiomyopathy and other causes of sudden cardiac death in young competitive athletes, with considerations for preparticipation screening and criteria for disqualification. Cardiol Clin. 2007;25(3):399–414.

    Article  PubMed  Google Scholar 

  56. Serota H, Barth 3rd CW, Seuc CA, Vandormael M, Aguirre F, Kern MJ. Rapid identification of the course of anomalous coronary arteries in adults: the “dot and eye” method. Am J Cardiol. 1990;65:891–8.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Heart and Vascular Center of Excellence, William Beaumont Hospital, Royal Oak, MI, USA

    Benjamin T. Ebner MD

  2. Department of Cardiovascular Medicine, William Beaumont Hospital, Royal Oak, MI, USA

    Kavitha M. Chinnaiyan MD

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  1. Benjamin T. Ebner MD
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  2. Kavitha M. Chinnaiyan MD
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Correspondence to Benjamin T. Ebner MD .

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  1. Interventional Cardiology Research, Beaumonth Health System, Royal Oak, Michigan, USA

    Amr E. Abbas

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Ebner, B.T., Chinnaiyan, K.M. (2015). Imaging of Coronary Artery Anomalies. In: Abbas, A. (eds) Interventional Cardiology Imaging. Springer, London. https://doi.org/10.1007/978-1-4471-5239-2_5

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  • DOI: https://doi.org/10.1007/978-1-4471-5239-2_5

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