Background: Anatomic variations and abnormalities of coronary arteries could affect the blood supply of the heart, hemodynamic characteristics and could be a risk of atherosclerosis. Knowledge about the variations of coronary artery origin and its course provides a valuable guide to Cardiothoracic Surgeons and Physicians and be useful for choosing the appropriate devices for such variant anatomical structures. The aim of the study was to estimate the prevalence of coronary artery anomalies among patients with fail ed coronary artery catheterization using CCTA to prevent misdiagnosis and reduce mismanagement of such anomalies. Methods: One hundred MDCT coronary angiography examinations were done using a 128detectors (Philips Healthcare Ingenuity) scanner for patients who had previously failed coronary artery catheterization. Dedicated software and post processing techniques were used for precise evaluation and description of the coronary artery tree to be a road map for future interventional procedures. Results: Class A coronary artery anomalies were found in 53.2% of the detected anomalies (25 / 47 anomalies) in 20% of the included patients while class B coronary artery anomalies were recorded in 46.8% of the detected anomalies (22 / 47 anomalies) in 19% of the included patients. No cases showed class C anomalies in our cohort. Significant coronary artery disease (CAD) had no significant association with the presence of coronary artery anomalies. Conclusions: Detection of different coronary artery anomalies among patients with previous failed coronary artery catheterization can help the cardiologists for better planning for the interventional procedures and better patient outcome.
Background: The common and potentially fatal disorder known as coronary artery disease (CAD) is characterised by turbulent and sluggish blood flow at the coronary artery bifurcation site, particularly at broader angles. Curved multiplanar reformat (CMPR) and 3D volume rendering (3D VR) techniques could help in prediction of CAD. Objective: The aim of the current study was to evaluate of the capability of Multi-detector CT (MDCT) coronary angiography to quantify coronary bifurcation angles for early preventative treatment or preprocedural planning for coronary intervention. Patients and methods: Using a 128-detectors scanner, 60 patients with typical or atypical chest discomfort or failed catheterization received MDCT coronary angiography to characterise coronary anatomy. Coronary bifurcation angles were calculated using specialised software and post-processing methods for correlation with CAD severity. Results: Compared to the 3D VR approach, the CMPR technique revealed wider values of coronary bifurcation angles. However, Bland-Altman plots showed that both methods may be alternatively used. Because a wider angle was linked to a greater degree of stenosis, LAD-LCX angle differed significantly between individuals with significant and nonsignificant CAD. Conclusion: Measurements of various coronary bifurcation angles, particularly the LAD-LCX angle, which is thought to be a predictor for CAD, can be made using MDCT coronary angiographic examination with CMPR and 3D VR methods. More plaques are likely to form when the angle is wider.
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