TITLE:
Coronary Artery Anomalies Detected by Multi-Detector Computed Tomography: A Single Centre Experience
AUTHORS:
Basma Hammad, Eman El-sharkawy, Yasser Morsi, Noha Shabaan, Salah Eltahan, Mohamed Elshafi, Shady Abohashem, Tanveer Mir, Mostafa Elwany
KEYWORDS:
Coronary Artery Anomalies, Spatial Resolution, Multi-Detector Computed Tomography
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.13 No.6,
June
9,
2023
ABSTRACT: Background:Coronary artery anomalies (CAA) prevalence represents less than 1% of congenital heart diseases. It includes anomalies in origin, course, and termination. Its detection has been easier with advances in imaging techniques using multi-detector computed tomography (MDCT). MDCT helpsnot only detection of the anomalous origin, but it allows delineation of the course and termination of the arteries, differentiation between benign and malignant courses, and guiding therapeutic interventions.Results:There wereconsecutivepatients withalow-to-intermediate probability of coronary artery diseasescanned with 128 MDCT. Each patient underwent a non-contrast prospectivegating acquisition for coronary calcium scoring followed by contrast-enhanced helical retrospective gated scans for the detection of coronary artery origin,course, termination, and detection of concomitant atherosclerosis. Wescanned 1000 patients with a mean age of 57.5±8.3,and68% were males. Thirty-twoanomalies were noted (3.2%) including; nineteen (1.9%) anomalous originfromthe opposite sinus, three (0.3%) anomalous left coronary arteriesfrom thepulmonary artery (ALCAPA), one (0.1%) super dominant left anterior descending artery (LAD) giving origin to the posterior descending artery (PDA), three single coronary arteries (0.3%)in which the left main (LM) and right coronary arteries were originating with a common stem from the right coronary sinus(RCS)and the LM took a pre-pulmonic course. Along with six (0.6%) dual LAD including five (0.5%) patients with type I (short LAD and long diagonal),there wasone (0.1%) type 4 with an extra LAD originating from the RCSwith a pre-pulmonic course.Conclusions:MDCT allows easy detection ofcoronary anomalies with high spatial resolution and overcomes limitations in conventional invasive coronary angiography. Based on our study we recommend the use of MDCT as an efficient and feasible modality for the diagnosis of coronary anomalies once this pathology is clinically suspected.