Dual source multidetector computed tomography coronary angiography in the surgical planning regarding the major coronary artery anomalies in children

Abstract

Background: This study aims to demonstrate major coronary artery anomalies such as anomalous origin and coronary artery fistulas on dual-source multi detector computed tomography (MDCT) coronary angiography in children before surgical treatment. Methods: Six children (3 boys, 3 girls; mean age 6 years; range 2 days to 15 years) referred for a MDCT coronary angiography for evaluation of coronary anomaly between January 2010 and June 2011 were included in this study. Electrocardiography (ECG)-gated dual-source MDCT coronary angiography was performed on all patients. No beta-blockers were given prior to the procedure. The mean heart rate was 98±20 bpm (range 128 to 75 bpm). In all patients, ostium, course, and end-distal portion of coronary artery were inspected for anomalies. Exact opening point was carefully assessed in patients with fistulas. Dual-source MDCT examination was performed with low kilovolt dose reduction algorithm (80 kV, range 150-350 mA) compatible with ALARA principles. Results: Three anomalous origin (one ALCAPA, two anomalous left main coronary artery originated from right sinus of Valsalva) and three fistulas (two coronary-cameral fistula, one left main coronary artery -coronary sinus fistula) were clearly identified with dual-source MDCT angiography. Conclusion: Dual source MDCT angiography is a noninvasive and effective method as an alternative to conventional coronary angiography for the preoperative assessment of major anomalous origin of coronary artery or coronary artery fistulas.