Abstract
Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals. Coronary computed tomography angiography delivers a three-dimensional view of excellent quality with information of the origin, course and anatomic relationships of the anomalous vessel, allowing differentiation between benign and malignant variants, entities that require different management and treatment. To show that coronary computed tomography angiography is the non-invasive technique of choice for the evaluation of a coronary anomaly due to its high diagnostic accuracy. Between 2008 and 2014, 368 coronary computed tomography angiographies were carried out. Six (1.6%) patients had a coronary anomaly. The age of these six patients ranged from 38 to 82 years (five were women). The coronary computed tomography angiography was requested due to cardiac symptoms (angina and dyspnea) in two patients, after a selective coronary arteriography to obtain additional information of the coronary anomaly in three patients, and after a cardiorespiratory arrest in one patient. Three patients had an anomaly of the right coronary artery, two patients had an anomaly of the left coronary artery and one patient had absent left main coronary artery. In five patients the coronary anomaly was malignant. Coronary computed tomography angiography is a robust diagnostic method to evaluate patients with suspected coronary anomalies.
Highlights
Role of coronary computed tomography angiography for the diagnosis of coronary anomalies Background: Coronary anomalies are rare heart diseases that can cause sudden cardiac death, especially in young individuals
A pesar de que la MCS puede ser la primera manifestación de una anomalías coronarias (AC), aproximadamente la mitad de los pacientes portadores de esta cardiopatía tiene síntomas cardiacos: palpitaciones, disnea, angina de esfuerzo o síncope[8,9,10]
Congenital coronary artery anomalies: diagnosis with 64 slice multidetector row computed tomography coronary angiography: a single-centre study
Summary
Todos los pacientes enviados para la realización de un ACTC al Servicio de Imagenología de Clínica Reñaca, entre octubre de 2008 a diciembre de 2014, fueron incluidos en el estudio. Un paciente tenía una arteria coronaria única que emergía del seno de Valsalva derecho (SVD), para luego dividirse en la arteria coronaria derecha (ACD) y tronco común izquierda (TCI) (Figura 2). El TCI, tenía un trayecto interarterial entre la aorta (AO) y el tracto de salida del ventrículo derecho (TSVD), para luego dividirse en la arteria descendente anterior (ADA) y la arteria circunfleja (ACX). Arriba izquierda: reconstrucción VR tridimensional del corazón en plano axial, muestra la arteria coronaria derecha (ACD) (Flecha celeste) que se origina en el seno de Valsalva derecho (SVD), pasa entre el tracto de salida del ventrículo derecho (TSVD) y la orejuela derecha, para luego tomar el surco aurículoventricular derecho hasta la cruz del corazón. Si alguna de las arterias coronarias se origina en la arteria pulmonar, o cuando el vaso anómalo que nace en el seno de Valsalva contralateral tiene un curso interarterial entre la AP y la AO19, y se demuestra isquemia o arritmia ventricular compleja en ejercicio
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