Anomalous Right Coronary Artery from the Pulmonary Artery: Noninvasive Diagnosis and Serial Evaluation

Su, Jason T.; Krishnamurthy, Rajesh; Chung, Taylor; Vick, G. Wesley; Kovalchin, John P.

doi:10.1080/10976640600843405

Cited by 26 publications

(34 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…19 Because symptoms in ARCAPA are less pronounced as compared with ALCAPA and can even remain unnoticed, prevalence figures are not very robust and are based on a limited number of case reports. 20 ARCAPA is generally not considered to be a lethal defect in infancy or childhood and often presents later in life.…”

Section: A B Cmentioning

confidence: 99%

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

Kate¹,

Weustink²,

Feyter³

2008

NHJL

View full text Add to dashboard Cite

Background. Before coronary evaluation by modern imaging techniques was feasible, premorbid diagnoses of coronary artery anomalies (CAAs) were usually made fortuitously by invasive coronary angiography (ICA). However, this technique is limited by its invasive and projectional nature. Coronary magnetic resonance angiography (CMRA) and multi-slice computed tomography (MSCT) broadened clinical information by enabling visualisation of the coronary arteries in their anatomical environment. Methods. This case series visualises and reviews anomalous coronary artery from the opposite sinus (ACAOS) and coronary artery fistulae. All CAAs were detected by means of 64-slice dual source computed tomography after 1000 cardiac scans at the Erasmus MC, Rotterdam, the Netherlands. Results. Eight ACAOS cases, one anomalous left coronary artery from the pulmonary artery (ALCAPA) and one congenital aneurysm of an aortic sinus were found. Seven out of ten detected CAAs were considered malignant whereas three CAAs of the ACAOS type (retroaortic path) were considered benign. Significant coronary artery disease was found in three out of eight ACAOS cases. In one of the ACAOS cases complete evaluation of the anomalous coronary artery was limited by motion artifacts. All five cases of right ACAOS were referred for MSCT because the right coronary artery could not be located by invasive angiography. Keywords: coronary anomalies, anomalous coronary artery from the opposite sinus, coronary artery fistulae, computed tomography, invasive coronary angiography Conclusion. All CAAs

show abstract

Section: A B Cmentioning

confidence: 99%

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

Kate¹,

Weustink²,

Feyter³

2008

NHJL

View full text Add to dashboard Cite

show abstract

“…There are Ͻ100 cases reported in the literature. [1][2][3][4] Age of presentation can be from infancy to late adulthood. Presentation can be with angina, heart failure, myocardial infarction, or sudden death and found at autopsy.…”

mentioning

confidence: 99%

“…Even in asymptomatic individuals, surgery is often the therapy of choice given the risks of an acute event; in 1 literature review, 15% of patients with isolated ARCAPA presented with a cardiac arrest or acute myocardial infarction. 1 Anomalous origin of the RCA from the pulmonary artery is known to be associated with other congenital heart diseases;…”

mentioning

confidence: 99%

“…[1][2][3] Cardiac magnetic resonance has been shown to be a useful noninvasive tool in determining the anatomy of anomalous coronary arteries and their course; anomalous coronary arteries can also be followed up with CMR after surgical reimplantation. 1 The mechanism for adenosine stress perfusion defects can be explained by the coronary steel phenomenon. This case is the first to report and illustrate how CMR with stress perfusion can provide both structural and functional information to guide the management of ARCAPA.…”

mentioning

confidence: 99%

“…[1][2][3] Patients with associated cardiac anomalies are diagnosed early in life compared to patients with isolated ARCAPA.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Isolated Anomalous Right Coronary Artery From the Pulmonary Artery in Adulthood

et al. 2012

View full text Add to dashboard Cite

A 51-year-old woman was admitted via the acute medical take after a prolonged episode of sharp central chest pain radiating to her neck and shoulder. The ECG was normal (Figure 1), as were subsequent consecutive troponin I measurements. Additional risk stratification with an exercise tolerance test was performed in consideration of her heavy smoking habit. At 85% of maximal predicted heart rate she developed chest pain and breathlessness with associated 2-mm inferolateral ST-segment depression ( Figure 2).Her coronary angiogram demonstrated unobstructed vessels but an unexpected anomalous origin of the right coronary artery (RCA) from the pulmonary artery (ARCAPA) with retrograde filling from the left system (Figure 3; online-only Data Supplement Movie I).A cardiovascular magnetic resonance (CMR) was requested to further delineate the anatomy and the ischemic burden. Turbo spin echoes T1-weighted images confirmed the origin of the RCA from the main pulmonary artery and its course between the aorta and the pulmonary trunk (Figure 4). Adenosine stress perfusion images showed an inducible perfusion defect in the RCA territory ( Figure 5; online-only Data Supplement Movie II). Left ventricular function was within normal limits, and there was no late gadolinium enhancement (ie, no myocardial scarring). After the CMR, the patient was referred to a cardiac surgeon for vessel reimplantation.Anomalous origin of the RCA from the pulmonary artery is a rare congenital coronary artery malformation. There are Ͻ100

show abstract