Coronary angioplasty of anomalous coronary arteries: Notes on technical aspects

Topaz, On; DiSciascio, Germano; Goudreau, Evelyne; Cowley, Michael J.; Nath, Amar; Kohli, Ravinder S.; Vetrovec, George W.

doi:10.1002/ccd.1810210213

Cited by 68 publications

(32 citation statements)

References 16 publications

(3 reference statements)

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“…28) Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery. 29,30) Some coronary artery anomalies have been correlated with sudden death, myocardial infarction, and anginal syndromes, and they need to be treated. 3,25) …”

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confidence: 99%

Primary Congenital Anomalies of the Coronary Arteries: A Coronary Arteriographic Study in Western Turkey

et al. 2005

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SUMMARYCoronary artery anomalies are found in 0.6% to 1.5% of coronary angiograms. Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery.We reviewed the database of the Cardiac Catheterization Laboratory of Uludag Medical University in Bursa, Turkey. All patients who were subjected to coronary angiography from 1994 to 2001 were included.The study included 12,059 patients who underwent diagnostic coronary arteriography during the 8 year period. One hundred patients had primary congenital coronary anomalies. Ninty-five (95%) of the patients had anomalies of origin and distribution while five (5%) had coronary artery fistulae. The left main coronary artery (LMCA) was the most common anomalous vessel involved (forty-eight (48%) of the patients). An LMCA distribution anomaly was observed in these 48 patients. An anomalous right coronary artery (RCA) was the second most common anomaly, seen in twenty-two (22%) of the patients. An anomalous circumflex artery (Cx) was the third most common anomaly, seen in seventeen. Five patients had a coronary artery fistulae. The fistulae in our series were small without significant shunt circulation.Primary congenital coronary anomalies are isolated lesions and generally have no relation with other congenital heart diseases. They do not appear to be associated with an increased risk for development of coronary atherosclerosis. Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery. (Int Heart J 2005; 46: 97-103)

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Section: )mentioning

confidence: 99%

Primary Congenital Anomalies of the Coronary Arteries: A Coronary Arteriographic Study in Western Turkey

et al. 2005

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“…While CAAs have not been strongly associated with congenital heart diseases and coronary atherosclerosis, recognition of CAAs is important for the appropriate diagnosis and management of patients undergoing coronary angioplasty or cardiac surgery. (7,8) Some CAAs are associated with anginal syndrome, myocardial infarction and sudden death, and therefore have to be treated. (9)(10)(11) The incidence of CAAs is generally reported to be about 0.2%-1.3%.…”

Section: Introductionmentioning

confidence: 99%

Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study

Altın¹,

Kanyilmaz²,

Koç³

et al. 2015

smedj

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INTRODUCTIONWith an increasing number of coronary angiography (CAG) procedures, coronary invasive procedures and cardiac bypass surgeries performed each day, knowledge of the variations, anomalies and anatomical pattern of coronary arteries is gaining in importance. Although many individuals have a normal coronary anatomy, variations and anomalies are not unusual, and may lead to complications during procedures. (1) There are two main coronary arteries that supply oxygenated blood to the myocardium -the left main coronary artery (LMCA) and the right coronary artery (RCA). The LMCA originates from the left sinus of Valsalva (SV), while the RCA originates from the right SV. There is typically no artery arising from the posterior SV. The LMCA bifurcates into the left anterior descending (LAD) artery and the circumflex artery (CXA). An additional artery called the intermediate artery (IMA) may arise at the bifurcation of the LMCA, forming a trifurcation.The LAD artery runs in the anterior interventricular sulcus, providing the penetrating septal branches. The left CXA runs along the left atrioventricular sulcus and gives rise to at least one obtuse marginal (OM) branch, while the RCA lies in the right atrioventricular sulcus and gives rise to the acute marginal branch. The IMA, which supplies the left ventricular free wall, is located anterior to the first OM artery and posterior to the first diagonal artery. It can also originate from the proximal part of the LMCA, LAD artery or CXA. In some cases, it is not possible to distinguish between the IMA and OM artery using anatomical or angiographic examinations. However, an important point of distinction is that the left ventricular free wall is supplied by the IMA.(1-3)The artery that supplies the posterior descending artery determines coronary dominance. Approximately 70%-80% of the general population is right-dominant (i.e. supplied by the RCA), while 5%-10% is left-dominant (i.e. supplied by the CXA) and 10%-20% is co-dominant (i.e. supplied by both the RCA and CXA).(3-5) A more accurate definition of dominance refers to the arterial supply to the atrioventricular nodal artery, which is generally supplied by the RCA. (3)(4)(5) Typically, there are two coronary ostia. However, in some cases where the LMCA is absent, three ostia can be detected.In individuals with such a condition, the LAD artery and CXA originate from different ostia. Absence of the LMCA is a common anomaly that can be detected in 0.4%-8% of the population. (4,5) Coronary arteries can be anatomically categorised into three groups based on their anatomical features: normal coronary anatomy, anatomic variations of the coronary artery and coronary artery anomalies (CAAs). CAAs, which are congenital disorders in the coronary anatomy that are observed in less than 1% of the general population, are evaluated using CAG series.

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“…2 When planning coronary angioplasty on anomalous coronary arteries, there is an even greater need to accurately define the origin and course of these vessels. 3 RCA may have clinical importance due to its course on the right atrium which may cause myocardial ischemia or myocardial infarction owing to surgical trauma. Here we present an anomalous right coronary artery coursing on the right atrium detected during CABG operation and confirmed by multislice computed tomography thereafter.…”

Section: Introductionmentioning

confidence: 99%

Right Coronary Artery Anomaly Coursing on the Right Atrium in a Patient Undergoing Coronary Artery Bypass Grafting

Çolak¹,

Erdil²,

Cansel³

et al. 2012

JIUMF

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Anomalous right coronary artery is a rare entity. Here we present an anomalous right coronary artery coursing on the right atrium detected during CABG operation and confirmed by multislice computed tomography thereafter. The images demonstrated that RCA arises from the right coronary sinus of Valsalva and runs forward between the pulmonary trunk and the right auricle. Then it was giving branch to the right ventricle and coursing approximately 0.5 cm on the right side of atrioventricular junction on the right atrium. Key Words: Coronary Vessel Anomaly; Coronary Artery Bypass; Coronary Disease. Koroner Arter Bypas Operasyonu Yapılan Bir Hastada Sağ Atrium Üzerinde Seyreden Sağ Koroner Arter AnomalisiSağ koroner arter anomalisi nadir bir anomali olup CABG operasyonu esnasında sağ atrium üzerinde seyrettiğini tespit ettiğimiz ve daha sonra da multislice bilgisayarlı tomografi ile kanıtladığımız sağ koroner arter anomalisini sunmayı amaçladık. Görüntülerde sağ koroner arterin, sağ koroner sinüsünden çıkmakta ve ana pulmoner arter ile sağ aurikula arasında ilerlemekte olduğu izledik. Anormal arter sağ ventrikül dalını verdikten sonra atrioventriküler bileşkenin 0,5 cm sağında sağ atrium üzerinde seyretmekte idi.

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Coronary angioplasty of anomalous coronary arteries: Notes on technical aspects

Cited by 68 publications

References 16 publications

Primary Congenital Anomalies of the Coronary Arteries: A Coronary Arteriographic Study in Western Turkey

Primary Congenital Anomalies of the Coronary Arteries: A Coronary Arteriographic Study in Western Turkey

Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study

Right Coronary Artery Anomaly Coursing on the Right Atrium in a Patient Undergoing Coronary Artery Bypass Grafting

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