Coronary artery anomalies — a short review

Zemánek, David; Veselka, Josef

doi:10.2478/s11536-007-0012-8

Cited by 5 publications

(6 citation statements)

References 37 publications

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“…We saw both forms of presentation, as described earlier; 75% were of the infant type, consistent with the medical literature. [1][2][3][4][5][6][7][8][9][10][11] Our suspicion of ALCAPA on the basis of the clinical and ECG find-…”

Section: Discussionmentioning

confidence: 99%

“…It is usually an isolated cardiac malformation. [1][2][3][4] The 2 clinical variants of ALCAPA, found in infants and older individuals, respectively, are distinguished by the presence or absence of adequate intercoronary collateral circulation that supplies blood from the right coronary artery (RCA) to the left side of the heart. 5 The 80% to 85% of patients without an adequate collateral supply typically present with congestive heart failure (CHF) secondary to ischemia within the first few months of life; their mortality rate is 90% without early surgical correction.…”

mentioning

confidence: 99%

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Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Rodríguez-González¹,

Tirado²,

Hosseinpour³

et al. 2015

Texas Heart Institute Journal

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Rodríguez-González¹,

Tirado²,

Hosseinpour³

et al. 2015

Texas Heart Institute Journal

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“…The small sample size of our study is another limitation. Surgical outcomes obtained in multi-institutional studies with greater sample size will be more accurate [19,20].…”

Section: Discussionmentioning

confidence: 99%

Coronary artery bypass graft surgery in the elderly patients

et al. 2009

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AbstractThe purpose of this retrospective study was to determine the results of coronary artery surgery in the elderly patients and to compare the outcome with a younger group. Two hundred thirteen patients aged 70 years and older who underwent on-pump coronary artery surgery were retrospectively studied and data were compared with those of 524 patients aged 50–69. The groups were similar with respect to preoperative characteristics except for sex distribution and the incidences of peripheral vascular disease and prior cerebrovascular accident. The use of internal mammarian artery grafts was significantly lower in the elderly patients (80.3% versus 91.6%, p<0.001). The 30-day mortality for the elderly group was 4.7% while that of younger group was 2.3%. The elderly patients had a significantly higher incidence of postoperative low cardiac output, pulmonary complications and acute renal failure. The elderly group also had also significantly longer intensive care unit length of stay (1.9 versus 1.7 days, p=0.006) and postoperative length of stay (10.1 versus 7.4 days, p<0.001). Although mortality and complication rates are higher, coronary artery surgery can be performed with acceptable risk in the elderly patients. Old age alone should not be a deterrent factor for surgical revascularization in coronary artery disease.

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“…Management of malignant coronary anomalies is controversial. In the last 40 years the management strategy has shifted from predominantly medical, with long‐term β‐blocking therapy, to almost exclusively surgical . Surgical treatment, nowadays, is generally recommended, but some authors do not suggest this approach for all patients .…”

Section: Discussionmentioning

confidence: 99%

The Role of Computed Tomography Coronary Angiography in the Management of Coronary Anomalies

et al. 2012

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Congenital abnormalities of coronary arteries are an uncommon cause of sudden cardiac death and are difficult to detect at coronary angiography. We describe two patients with acute coronary syndrome and non-occlusive coronary artery disease in which a 64-multidetector computed tomography (MDCT) coronary angiography showed the presence of a malignant coronary anomaly. Sixty-four-MDCT with the possibility of 3D reconstructions allows for easier diagnosis of coronary anomalies and provides essential details necessary for operative intervention. doi: 10.1111/jocs.12040 (J Card Surg 2013;28:33-36) Congenital abnormalities of coronary arteries may be found incidentally in 0.3% to 1% of healthy individuals. 1They are an uncommon but important cause of chest pain, myocardial ischemia, and syncope and, above all, they carry a high risk for sudden cardiac death (up to 30% of patients), particularly before 35 years of age. 2The detection and characterization of these anomalies is crucial for the management of these patients. We describe two cases of patients with angina but nonsignificant coronary artery disease at angiography in which the coronary anomaly was diagnosed using a 64-MDCT (Light Speed VCT, General Electrics, Milwaukee, WI). The usefulness of this non-invasive diagnostic tool in the diagnosis of the coronary anomalies is the subject of this clinical review. PATIENT 1A 66-year-old female with hypertension presented with sudden chest pain. The electrocardiogram (ECG) showed sinus rhythm with ST elevation in V2 and V3 leads. Blood tests revealed a slight increase of T-troponine (0.06 ng/mL-normal values 0.01 to 0.03 ng/mL). The patient underwent conventional coronary angiography (CCA) which revealed a myocardial bridge of the anterior descending artery and an anomalous origin of the right coronary artery (RCA), with no significant disease of the other epicardial vessels (Fig. 1a). Computed tomography coronary angiography (CTCA) confirmed the absence of significant atherosclerosis and the presence of a short intramyocardial path of the anterior descending coronary artery (Fig. 1c) and, in addition, revealed the aberrant origin of the RCA from the opposite coronary sinus (Fig. 1b). The patient, though informed about potential risks associated with this anomaly and available therapeutic options, refused any surgical intervention and agreed to long-term b-blocker medical therapy with a strict follow-up. She has remained asymptomatic at one-year follow-up. PATIENT 2A 49-year-old male presented with chest pain. ECG showed sinus rhythm with ST elevation in all the electrocardiographic leads; the echocardiogram was normal; blood T-troponine values were 0.05 ng/mL. The patient underwent coronary angiography that showed non-occlusive coronary artery disease and revealed an aberrant origin of the dominant RCA from the left Disclosures: none.

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Coronary artery anomalies — a short review

Cited by 5 publications

References 37 publications

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery: Diagnoses and Surgical Results in 12 Pediatric Patients

Coronary artery bypass graft surgery in the elderly patients

The Role of Computed Tomography Coronary Angiography in the Management of Coronary Anomalies

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