Fused cardiac hybrid imaging with coronary computed tomography angiography and positron emission tomography in patients with complex coronary artery anomalies

Gräni, Christoph; Benz, Dominik C.; Possner, Mathias; Clerc, Olivier; Mikulicic, Fran; Vontobel, Jan; Stehli, Julia; Fuchs, Tobias A.; Pazhenkottil, Aju P.; Gaemperli, Oliver; Kaufmann, Philipp A.; Buechel, Ronny R.

doi:10.1111/chd.12402

Cited by 24 publications

(20 citation statements)

References 41 publications

(81 reference statements)

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“…This approach is supported by most authors 1 . A recent small case series by Gräni et al 7 suggested hybrid imaging with coronary computed tomography angiography and positron emission tomography is superior to perfusion imaging alone at detecting impaired myocardial blood flow in patients with complex coronary artery anomalies. The significance of such changes has yet to be assessed prognostically but could potentially aid risk stratification in such patients.…”

Section: Discussionmentioning

confidence: 87%

Endocarditis and coronary artery fistula: a case report†

Green

Crilley

2018

European Heart Journal - Case Reports

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IntroductionCoronary artery fistulae are rare abnormal congenital communications between a coronary artery and a cardiac chamber or great vessel. The majority of adult patients are asymptomatic, and it is most commonly discovered incidentally on coronary angiography.Case PresentationWe present the case of a 50-year-old woman, with a known fistula connecting the right coronary artery (RCA) and right atrium (RA), presenting with aortic valve endocarditis and pulmonary emboli. We detail the presentation and echocardiographic findings of aortic valve endocarditis with extension of the vegetation into the RA via the giant RCA fistula. We describe the clinical course including initial therapy, embolization of the right atrial vegetation to the lungs, and ultimately successful surgical correction after prolonged antibiotic therapy.DiscussionPatients with coronary artery fistulae are susceptible to potentially serious complications including myocardial ischaemia, shunting and in this case infective endocarditis. We review the literature and discuss timings for corrective intervention.

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Section: Discussionmentioning

confidence: 87%

Endocarditis and coronary artery fistula: a case report†

Green

Crilley

2018

European Heart Journal - Case Reports

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“…Advising patients to continue sports at a REC level might be a reasonable option in this setting. Therefore, decisions towards patient management should only be made after implementing clinical data, such as sport- and nonsport-related symptoms, previous sports behavior, the anatomic features of ACAOS, age, and noninvasive stress test results [32-34]. This hypothesis has to be evaluated in larger, multicenter registries in order to adapt recommendations/guidelines.…”

Section: Discussionmentioning

confidence: 99%

Sports Behavior in Middle-Aged Individuals with Anomalous Coronary Artery from the Opposite Sinus of Valsalva

et al. 2018

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Objectives: Recommendations regarding sports restriction are lacking for middle-aged athletes with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). Methods: Sixty-three patients with ACAOS were subdivided into ACAOS with (n = 38) or without (n = 25) an interarterial course (IAC). Sports behavior, either competitive (COMP) or recreational (REC), was evaluated at the time of diagnosis and after a median follow-up of 4.2 years. Results: Mean age was 56 ± 11 years and 48 (76.2%) patients were engaged in sports. Three individuals (4.8%) were surgically corrected after diagnosis. Thirty-eight (60.3%) patients were aware of their diagnosis at follow-up and 12 (19.0%) were counseled by their physician about sports restrictions. Sports behavior at the time of diagnosis and at follow-up did not differ significantly, neither in patients engaged in COMP (17.5 vs. 12.7%, p = 0.619) nor those engaged in REC (58.7 vs. 61.9%, p = 0.856). Sport-related symptoms were not significantly different between ACAOS patients with and without IAC. No athlete had died at follow-up. Conclusions: The majority of middle-aged individuals with ACAOS were involved in sports activities at the time of diagnosis and at follow-up. Awareness and counseling about ACAOS diagnosis had no significant effect on sports behavior. IAC did not have an impact on sport-related symptoms, and outcomes were favorable in all athletes, regardless of surgical correction.

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“…However, studies comparing hybrid imaging with either stand-alone or side-by-side interpretation of the datasets have shown that interpretation was changed based on fused images in almost one-third of patients evaluated for suspected obstructive CAD [ 198 – 201 ]. Additional patient groups in which hybrid imaging has been shown to provide complementary information are those with congenital coronary anomalies [ 202 ] and patients with recurrent chest pain after CABG [ 203 ]. Furthermore, hybrid imaging can identify patients with microvascular dysfunction without obstructive CAD [ 204 ].…”

Section: Perspectives For Pet Mpimentioning

confidence: 99%

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

Sciagrà

Lubberink

Hyafil

et al. 2020

Eur J Nucl Med Mol Imaging

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The use of cardiac PET, and in particular of quantitative myocardial perfusion PET, has been growing during the last years, because scanners are becoming widely available and because several studies have convincingly demonstrated the advantages of this imaging approach. Therefore, there is a need of determining the procedural modalities for performing high-quality studies and obtaining from this demanding technique the most in terms of both measurement reliability and clinical data. Although the field is rapidly evolving, with progresses in hardware and software, and the near perspective of new tracers, the EANM Cardiovascular Committee found it reasonable and useful to expose in an updated text the state of the art of quantitative myocardial perfusion PET, in order to establish an effective use of this modality and to help implementing it on a wider basis. Together with the many steps necessary for the correct execution of quantitative measurements, the importance of a multiparametric approach and of a comprehensive and clinically useful report have been stressed.

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Fused cardiac hybrid imaging with coronary computed tomography angiography and positron emission tomography in patients with complex coronary artery anomalies

Cited by 24 publications

References 41 publications

Endocarditis and coronary artery fistula: a case report†

Endocarditis and coronary artery fistula: a case report†

Sports Behavior in Middle-Aged Individuals with Anomalous Coronary Artery from the Opposite Sinus of Valsalva

EANM procedural guidelines for PET/CT quantitative myocardial perfusion imaging

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