Abstract
Anomalies of the coronary arteries are congenital and in most of the cases asymptomatic, although they may present with severe symptoms such as angina pectoris or cardiac arrest. Multidetector CT coronary angiography (MDCT-CA) permits, through curved multiplanar reconstructions and three-dimensional reformatting, noninvasive visualisation of the coronary tree and its variants and anomalies, providing a more accurate alternative to conventional coronary angiography (CCA). The purpose of this pictorial essay is to describe the main variants and anomalies of the coronary arteries using MDCT imaging with multiplanar and three-dimensional reconstructions.
Riassunto
Le anomalie delle arterie coronariche sono presenti alla nascita nella maggior parte dei casi asintomatiche ma possono manifestarsi con sintomatologia severa quale angina pectoris o addirittura l’arresto cardiaco. L’angiografia coronarica mediante tomografia computerizzata multistrato (TCMS) permette, tramite ricostruzioni multiplanari secondo piani curvilinei e riformattazioni 3D, la visualizzazione dell’albero coronarico e delle sue varianti ed anomalie in maniera non invasiva, fornendo migliore e più accurata alternativa alla angiografia coronarica (AC). Lo scopo di questo pictorial consiste nella descrizione mediante immagini TCMS con ricostruzioni multiplanari e 3D delle principali varianti e anomalie delle arterie coronarie.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References/Bibliografia
Angelini P, Velasco JA, Flamm S (2002) Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 105:2449–2454
Cademartiri F, Marano R, Luccichenti G et al (2004) Normal anatomy of the vessels of the heart with 16-row multislice computed tomography. Radiol Med (Torino) 107:11–21
Angelini P (2002) Coronary artery anomalies-current clinical issues: definitions, classification, incidence, clinical relevance, and treatment guidelines. Tex Heart Inst J 29:271–278
Rigatelli G (2003) Coronary artery anomalies: what we know and what we have to learn. A proposal for a new clinical classification. Ital Heart J 4:305–310
Baltaxe HA, Wixson D (1977) The incidence of congenital anomalies of the coronary arteries in the adult population. Radiology 122:47–52
Cademartiri F, Runza G, Luccichenti G et al (2006) Coronary artery anomalies: incidence, pathophysiology, clinical relevance and role of diagnostic imaging. Radiol Med (Torino) 111:376–391
Roberts WC (1986) Major anomalies of coronary arterial origin seen in adulthood. Am Heart J 111:941–963
Ogden JA (1969) Anomalous aortic origin. Circumflex, anterior descending, or main left coronary arteries. Arch Pathol 88:323–328
Danias PG, Stuber M, McConnell MV, Manning WJ (2001) The diagnosis of congenital coronary anomalies with magnetic resonance imaging. Coron Artery Dis 12:621–626
Spindola-Franco H, Grose R, Solomon N (1983) Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications. Am Heart J 105:445–455
Lee SS, Wu TL (1972) The role of the mural coronary artery in prevention of coronary atherosclerosis. Arch Pathol 93:32–35
Mohlenkamp S, Hort W, Ge J, Erbel R (2002) Update on myocardial bridging. Circulation 106:2616–2622
Hartnell G (2002) Coronary-artery fistula. N Engl J Med 347:950–951
Balanescu S, Sangiorgi G, Castelvecchio S et al (2001) Coronary artery fistulas: clinical consequences and methods of closure. A literature review. Ital Heart J 2:669–676
Lipton MJ, Barry WH, Obrez I et al (1979) Isolated single coronary artery: diagnosis, angiographic classification, and clinical significance. Radiology 130:39–47
Basso C, Corrado D, Thiene G (2001) Congenital coronary artery anomalies as an important cause of sudden death in the young. Cardiol Rev 9:312–317
Taylor AJ, Rogan KM, Virmani R (1992) Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol 20:640–647
Radke PW, Messmer BJ, Haager PK, Klues HG (1998) Anomalous origin of the right coronary artery: preoperative and postoperative hemodynamics. Ann Thorac Surg 66:1444–1449
Markis JE, Joffe CD, Cohn PF et al (1976) Clinical significance of coronary arterial ectasia. Am J cardiol 37:217–222
Chu E, Cheitlin MD (1993) Diagnostic considerations in patients with suspected coronary artery anomalies. Am Heart J 126:1427–1438
Agatston AS, Janowitz WR, Hildner FJ et al (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832
Topaz O, DeMarchena EJ, Perin E et al (1992) Anomalous coronary arteries: angiographic findings in 80 patients. Int J Cardiol 34:129–138
Samarendra P, Kumari S, Hafeez M et al (2001) Anomalous circumflex coronary artery: benign or predisposed to selective atherosclerosis. Angiology 52:521–526
Feldman CL, Ilegbusi OJ, Hu Z et al (2002) Determination of in vivo velocity and endothelial shear stress patterns with phasic flow in human coronary arteries: a methodology to predict progression of coronary atherosclerosis. Am Heart J 143:931–939
Click RL, Holmes DR Jr, Vlietstra RE et al (1989) Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival-a report from the Coronary Artery Surgery Study. J Am Coll Cardiol 13:531–537
Garg N, Tewari S, Kapoor A et al (2000) Primary congenital anomalies of the coronary arteries: a coronary: arteriographic study. Int J Cardiol 74:39–46
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Malagò, R., D’Onofrio, M., Brunelli, S. et al. Anatomical variants and anomalies of the coronary tree studied with MDCT coronary angiography. Radiol med 115, 679–692 (2010). https://doi.org/10.1007/s11547-010-0522-3
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11547-010-0522-3