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Coronary CTA assessment of coronary anomalies |
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| Authors: | Pursnani Amit Jacobs Jill E Saremi Farhood Levisman Jeffrey Makaryus Amgad N Capuñay Carlos Rogers Ian S Wald Christoph Azmoon Shah Stathopoulos Ioannis A Srichai Monvadi B |
| Institution: | a Temple University School of Medicine, Division of Cardiology, Pennsylvania, PA, USA b NYU School of Medicine, Department of Radiology, 550 First Avenue, New York, NY 10016, USA c USC, Keck School of Medicine, Department of Radiology, Los Angeles, CA, USA d UC Davis Medical Center, Division of Cardiology, Sacramento, CA, USA e Hofstra North Shore-LIJ School of Medicine at Hofstra University, Department of Cardiology, North Shore University Hospital, Manhasset, NY, USA f Diagnóstico Maipú, Department of Computed Tomography, Buenos Aires, Argentina g Stanford University, Division of Cardiovascular Medicine, Stanford, CA, USA h Lahey Clinic Medical Center, Department of Radiology, Burlington, MA, USA i University of Florida, Department of Cardiology, Jacksonville, FL, USA j Lenox Hill Heart and Vascular Institute of New York, Department of Interventional Cardiac and Vascular Services, New York, NY, USA |
| Abstract: | Coronary anomalies occur in <1% of the general population and can range from a benign incidental finding to the cause of sudden cardiac death. The coronary anomalies are classified here according to the traditional grouping into those of origin and course, intrinsic arterial anatomy, and termination. Classic coronary anomalies of origin and course include those in which a coronary artery originates from the contralateral aortic sinus or the pulmonary artery with anomalous course. Single coronary artery anomalies, in which single coronary artery branches to supply the entire coronary tree, are also included in this category. Anomalies of intrinsic arterial anatomy are a broad class that includes myocardial bridges, coronary ectasia and aneurysms, subendocardial coursing arteries, and coronary artery duplication. Coronary anomalies of termination are those in which a coronary artery terminates in a fistulous connection to a great vessel or cardiac chamber. In the case of those anomalies associated with a risk of sudden cardiac death, the relevant imaging features on CT angiography (CTA) associated with poorer prognosis are reviewed. Recent guidelines and appropriateness criteria favor the use of coronary CTA for the evaluation of coronary anomalies. Although invasive angiography has historically been used to diagnose coronary anomalies, multidetector CT imaging techniques have now become an accurate noninvasive alternative. Cardiac CTA provides excellent spatial and temporal resolution, allowing accurate anatomical assessment of these anomalies. |
| Keywords: | Coronary anomalies Computed tomography Angiography |
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