The incidence of coronary anomalies on routine coronary computed tomography scans

Kanber Ocal Karabay,Gurkan Geceer,Bayram Bagirtan,Ender Uysal,Abdulmelik Yildiz

doi:10.5830/cvja-2013-066

Abstract

SummaryObjectiveThis study aimed to assess the incidence of coronary anomalies using 64-multi-slice coronary computed tomography (MSCT).MethodsThe diagnostic MSCT scans of 745 consecutive patients were reviewed.ResultsThe incidence of coronary anomalies was 4.96%. The detected coronary anomalies included the conus artery originating separately from the right coronary sinus (RCS) (n = 8, 1.07%), absence of the left main artery (n = 7, 0.93%), a superior right coronary artery (RCA) (n = 7, 0.93%), the circumflex artery (CFX) arising from the RCS (n = 4, 0.53%), the CFX originating from the RCA (n = 2, 0.26%), a posterior RCA (n = 1, 0.13%), a coronary fistula from the left anterior descending artery and RCA to the pulmonary artery (n = 1, 0.13%), and a coronary aneurysm (n = 1, 0.13%).ConclusionsThis study indicated that MSCT can be used to detect common coronary anomalies, and shows it has the potential to aid cardiologists and cardiac surgeons by revealing the origin and course of the coronary vessels.

Highlights

The detected coronary anomalies included the conus artery originating separately from the right coronary sinus (RCS) (n = 8, 1.07%), absence of the left main artery (n = 7, 0.93%), a superior right coronary artery (RCA) (n = 7, 0.93%), the circumflex artery (CFX) arising from the RCS (n = 4, 0.53%), the CFX originating from the RCA (n = 2, 0.26%), a posterior RCA (n = 1, 0.13%), a coronary fistula from the left anterior descending artery and RCA to the pulmonary artery (n = 1, 0.13%), and a coronary aneurysm (n = 1, 0.13%)
Two experienced radiologists and three invasive cardiologists who were familiar with CCA retrospectively interpreted 745 diagnostic scans of 745 consecutive patients taken between July 2007 and December 2011 at Istanbul Kadikoy Florence Nightingale Hospital
The patients with detected coronary anomalies included eight with the conus artery originating separately from the right coronary sinus (RCS) (1.07%), seven with absence of the left main artery (0.93%), seven with a superior right coronary artery (RCA) (0.93%), four with the circumflex artery (CFX) arising from the RCS (0.53%), two with the CFX originating from the RCA (0.26%), one with a posterior origin of the RCA (0.13%), one with a coronary fistula from the left anterior descending artery and RCA to the pulmonary artery (0.13%), and one with a coronary artery aneurysm (0.13%)

Summary

Methods

Our institutional ethics committee approved the study protocol. Two experienced radiologists and three invasive cardiologists who were familiar with CCA retrospectively interpreted 745 diagnostic scans of 745 consecutive patients taken between July 2007 and December 2011 at Istanbul Kadikoy Florence Nightingale Hospital. Patients received a 50- to 100-mg oral dose of metoprolol one hour prior to the scan, with additional intravenous (IV) metoprolol administered immediately prior to the scan if necessary. All patients received sublingual isosorbide dinitrate immediately prior to starting the scan protocol. Computed tomography coronary angiography was carried out using a 64-MSCT scanner (General Electric Light Speed VCT scanner, Waukesha, WI, USA) after IV injection of 80 ml of non-ionic contrast medium (Iopamiro 370; Bracco, Milan, Italy) as a bolus dose at a rate of 6 ml/s with retrospective ECG gating. Retrospective ECG-gated images were obtained during one held breath. These images were evaluated with multiplanar reconstruction, maximum-intensity projection and threedimensional volume-rendering methods. The right coronary artery (RCA) was evaluated at either the 45 or 75% phase of the cardiac cycle, depending on which phase presented the least amount of motion

Results

Discussion

Conclusions