ISSN: 1899-0967
Polish Journal of Radiology
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vol. 83
Original paper

Anatomical variants and coronary anomalies detected by dual-source coronary computed tomography angiography in North-eastern Thailand

Narumol Chaosuwannakit

© Pol J Radiol 2018; 83: e372-e378
Online publish date: 2018/09/17
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Congenital coronary anomalies are uncommon, with an incidence ranging from 0.17% in autopsy cases to 1.2% in angiographically evaluated cases. The recent development of dual-source coronary computed tomography angiography (coronary CTA) allows accurate and noninvasive depiction of coronary artery anomalies.

Material and methods
A retrospective study included a total of 924 patients who underwent coronary CTA because of known or suspected coronary artery disease. In each study, coronary artery anomalies (CAs) were investigated.

A total of 924 patients (mean age 51.2 ±12.8 years), who underwent dual-source coronary CTA, were studied. The overall prevalence of CAs in our study was 3.7%, with the following distribution: four single coronary artery, 14 anomalous origin from opposite sinus of Valsalva, three absent left main, four high take-off coronary artery, three anomalous left coronary artery from pulmonary artery, and eight coronary artery fistulas.

The present study supports the use of coronary CTA as a reliable noninvasive tool for defining anomalous coronary arteries in an appropriate clinical setting and provides detailed three-dimensional anatomic information that may be difficult to obtain with invasive coronary angiography.


anomalous coronary artery, prevalence, coronary CTA

Kardos A, Babai L, Rudas L, et al. Epidemiology of congenital coronary artery anomalies: a coronary arteriography study on a central European population. Cathet Cardiovasc Diagn 1997; 42: 270-275.
Yamanaka O, Hobbs RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990; 21: 28-40.
Angelini P, Velasco JA, Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation 2002; 105: 2449-2454.
Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation 2007; 115: 1296-1305.
Ishikawa T, Brandt PW. Anomalous origin of the left main coronary artery from the right anterior aortic sinus: angiographic definition of anomalous course. Am J Cardiol 1985; 55: 770-776.
Dhoble A, Dewar J, Szerlip M, Abidov A. Rare coronary anomaly: Common origin of major coronary arteries from the right sinus of Valsalva and a small ramus branch originating from the left sinus of Valsalva. Int J Cardiol 2012; 28: e3-4.
Ghadri JR, Kuest SM, Goetti R, et al. Image quality and radiation dose comparison of prospectively triggered low-dose CORONARY CTA: 128-slice dual-source high-pitch spiral versus 64-slice single-source sequential acquisition. Int J Cardiovasc Imaging 2012; 28: 1217-1225.
Achenbach S, Marwan M, Ropers D, et al. Coronary computed tomography angiography with a consistent dose below 1 mSv using prospectively electrocardiogram-triggered high-pitch spiral acquisition. Eur Heart J 2010; 31: 340-346.
Herzog BA, Wyss CA, Husmann L, et al. First head-to head comparison of effective radiation dose from low-dose 64-slice CT with prospective ECG-triggering versus invasive coronary angiography. Heart 2009; 95: 1656-1661.
Taylor AJ, Cerqueira M, Hodgson JM, et al. ACCF/SCCT/ACR/AHA/ASE/ASNC 2010 Appropriate Use Criteria for Cardiac Computed Tomography: a report of the American College of Cardiology/ Foundation Appropriate Use Criteria Task Force Society of Cardiovascular Computed Tomography/American College of Radiology/American Heart Association/American Society of Echocardiography/American Society of Nuclear Cardiology/Society for Cardiovascular Angiography and Interventions/Society for Cardiovascular Magnetic Resonance. J Am Coll Cardiol 2010; 56: 1864-1894.
von Ziegler F, Pilla M, McMullan L, et al. Visualization of anomalous origin and course of coronary arteries in 748 consecutive symptomatic patients by 64-slice computed tomography angiography. BMC Cardiovasc Disord 2009; 11: 9-54.
Sundaram B, Kreml R, Patel S. Imaging of coronary artery anomalies. Radiol Clin North Am 2010; 48: 711-727.
Xu H, Zhu Y, Zhu X, et al. Anomalous coronary arteries: depiction at dual-source computed tomographic coronary angiography. J Thorac Cardiovasc Surg 2010; 143: 1286-1291.
Kacmaz F, Isiksalan N, Alyan O, et al. Imaging of coronary artery anomalies: the role of multidetector computed tomography. Coron Artery Dis 2008; 19: 203-209.
Kim SY, Seo JB, Do KH, et al. Coronary artery anomalies: classification and ECG-gated multi-detector row CT findings with angiographic correlation. Radiographics 2006; 26: 317-333.
Young PM, Gerber TC, Williamson EE, et al. Cardiac imaging: part 2, normal, variant, and anomalous configurations of the coronary vasculature. AJR Am J Roentgenol 2011; 197: 816-826.
Namgung J, Kim JA. The prevalence of coronary anomalies in a single center of Korea: origination, course, and termination anomalies of aberrant coronary arteries detected by ECG-gated cardiac MDCT. BMC Cardiovasc Disord 2014; 14: 48.
Zeina AR, Blinder J, Sharif D, et al. Congenital coronary artery anomalies in adults: non-invasive assessment with multidetector CT. Br J Radiol 2009; 82: 254-261.
Koşar P, Ergun E, Öztürk C, Koşar U. Anatomic variations and anomalies of the coronary arteries: 64-slice CT angiographic appearance. Diagn Interv Radiol 2009; 15: 275-283.
Hacioglu Y, Budoff M. Is the left anterior descending artery really absent? – a decisive input from coronary CT angiography. Catheter Cardiovasc Interv 2010; 76: 117-120.
Cho SH, Joo HC, Yoo KJ, Youn YN. Anomalous origin of right coronary artery from left coronary sinus: surgical management and clinical result. Thorac Cardiovasc Surg 2015; 63: 360-366.
Click RL, Holmes DR Jr, Vliestra RE, et al. Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival- a report from the coronary artery surgery study. J Am Coll Radiol 1989; 13: 531-537.
Dodd JD, Ferencik M, Liberthson RR, et al. Congenital anomalies of coronary artery origin in adults: 64-MDCT appearance. AJR 2007; 188: 138-146.
Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital artery anomalies. J Am Coll Radiol 1992; 20: 640-647.
Krupiński M, Urbańczyk-Zawadzka M, Laskowicz B, et al. Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: “High-risk” anatomy and its clinical relevance. Eur Radiol 2014; 24: 2353-2359.
Desmet W, Vanhaecke J, Vrolix M, et al. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J 1992; 13: 1637-1640.
Desmet W, Vanhaecke J, Vrolix M, et al. Isolated single coronary artery: a review of 50,000 consecutive coronary angiographies. Eur Heart J 1992; 13: 1637-1640.
Aldana-Sepulveda N, Restrepo CS, Kimura-Hayama E. Single coronary artery: spectrum of imaging findings with multidetector CT. J Cardiovasc Comput Tomogr 2013; 7: 391-399.
Patel KB, Gupta H, Nath H, et al. Origin of all three major coronary arteries from the right sinus of Valsalva: clinical, angiographic, and magnetic resonance imaging findings and incidence in a select referral population. Catheter Cardiovasc Interv 2007; 69: 711-718.
Alegria JR, Herrmann J, Holmes DR, Jr, et al. Myocardial bridging. Eur Heart J 2005; 26: 1159-1168.
Nakanishi R, Rajani R, Ishikawa Y, et al. Myocardial bridging on coronary CTA: an innocent bystander or a culprit in myocardial infarction? J Cardiovasc Comput Tomogr 2012; 6: 3-13.
Armsby L, Keane J, Sherwood M, et al. Management of coronary artery fistulae patient selection and results of transcatheter closure. J Am Coll Cardiol 2002; 39: 1026-1032.
Manghat NE, Morgan-Hughes JG, Marshall AJ, Roobottom CA. Multidetector row computed tomography: imaging congenital coronary artery anomalies in adults. Heart 2005; 91: 1515-1522.
Zhou CS, Zhang LJ, Wang YN, et al. Incidence and classification diagnosis of coronary artery fistula at dual-source CT coronary angiography. Zhonghua Yi Xue Za Zhi 2012; 92: 3336-3340.
Zenooz NA, Habibi R, Mammen L, et al. Coronary artery fistulas: CT findings. Radiographics 2009; 29: 781-789.
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