Anomalous origin of the coronary artery arising from the opposite sinus: prevalence and outcomes in patients undergoing coronary CTA

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art_CHEEZUM_Anomalous_origin_of_the_coronary_artery_arising_from_2017.PDF (814.61 KB)
Citações na Scopus
74
Tipo de produção
article
Data de publicação
2017
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
OXFORD UNIV PRESS
Autores
CHEEZUM, Michael K.
GHOSHHAJRA, Brian
HULTEN, Edward A.
BHATT, Ami
MOUSAVI, Negareh
SHAH, Nishant R.
VALENTE, Anne Marie
RYBICKI, Frank J.
STEIGNER, Michael
Citação
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, v.18, n.2, p.224-235, 2017
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Aims The impact of coronary computed tomographic angiography (CTA) on management of anomalous origin of the coronary artery arising from the opposite sinus (ACAOS) remains uncertain. We examined the prevalence, anatomical characterization, and outcomes of ACAOS patients undergoing CTA. Methods and results Among 5991 patients referred for CTA at two tertiary hospitals between January 2004 and June 2014, we identified 103 patients (1.7% prevalence) with 110 ACAOS vessels. Mean age was 52 years (range 5-83, 63% male), with 55% previously known ACAOS and 45% discovered on CTA. ACAOS subtypes included: 39% interarterial (n = 40 anomalous right coronary artery, n = 3 anomalous left coronary artery), 38% retroaortic, 15% subpulmonic, 5% prepulmonic, and 2% other. ACAOS patients were assessed for symptoms, ischaemic test results, revascularization, all-cause or cardiovascular (CV) death, and myocardial infarction. CTAs were reviewed for ACAOS course, take-off height and angle, length and severity of proximal narrowing, intramural course, and obstructive coronary artery disease (CAD). In follow-up (median 5.8 years), there were 20 surgical revascularizations and 3 CV deaths. After adjusting for obstructive CAD (n = 21/103, 20%), variables associated with ACAOS revascularization included the following: CV symptoms, proximal vessel narrowing >= 50%, length of narrowing.5.4 mm, and an interarterial course. Conclusion The prevalence of ACAOS on CTA was 1.7%, including 45% of cases discovered incidentally. CTA provided excellent characterization of ACAOS features associated with coronary revascularization, including the length and severity of proximal vessel narrowing.
Palavras-chave
anomalous coronary artery, coronary computed tomographic angiography, prognosis, revascularization, sudden cardiac death
URI
https://observatorio.fm.usp.br/handle/OPI/21607
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Coleções
Artigos e Materiais de Revistas Científicas - HU
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - ODS/03