CT Angiography of the Heart in the Diagnosis of Abnormal and Atypical Coronary Artery Anatomy in Adult Patients of the Cardiac Surgical Profile

Inna Rychina, Maria Shlyappo, Vladimir Makarenko

A.N. Bakulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–A

Abstract

Anomalies of the coronary arteries (ACA) is rarely found category malformations of the heart, covering a wide range of options for abnormal anatomy of coronary vessels. Purpose: to present the universal standard systematic approach to defining CA and rare variants of normal CA anatomy by CT-angiography. Materials and methods: During the last 10 years in A.N.Bakulev Scientific Center for Cardiovascular Surgery performed 4554 CT-angiography of the heart and CA.The mean age was 45+27years.There were 2732(60%) men and 1822(40%) women. For analyzing the images of CA we used a universal standardized systematic approach.Results:anomalies of the coronary arteries was detected in 16(0,6%) patients. In 7(44%) of them were identified coronary heart fistula, in 9(56%) patients – anomalous origin of the left coronary artery from thepulmonary artery in 3(33,4%) patients, in 1(11,1%) patients-vertical ectopia outfall RCA; in 1(11,1%)patient left main coronary artery departed from the right coronary aortic sinus and followed inter-arterial, and 1(11,1%) patient RCA depart from LAD and followed subpulmonaly, in 2(22,2%) patients RCA departed from the left coronary aortic sinus, followed by inter- arterial, had a slit mouth and an acute angle of insertion, in 1(11,1%) patient was atresia of the mouth circumflex artery. Rare atypical variants of normal anatomy CA were detected in 25(1%) patients. Increasing the number of the mouths of facial sinuses aortic identified in 6(24%) patients, insertion CX from RCA and atypically retro-aortic following outgoing artery-in 4(16%) patients, insertion of CX from the right coronary sinus of the aorta with a retro-aortic following-in 1(4%) patients, and double or parallel LAD–in 1(4%) patients. Muscle bridges were diagnosed in 13(52%) patients.Conclusion: Using the universal standardized systematic approach in the analysis of images obtained by CT-angiography, can effectively differentiate between different versions of a wide range of normal and abnormal anatomy of the CA, which is of particular importance for patients cardiac surgery profile.