Document Detail

Role of MDCT coronary angiography in the evaluation of septal vs interarterial course of anomalous left coronary arteries.
MedLine Citation:
PMID:  20444667     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Conventional coronary angiography (CCA) may be inaccurate to distinguish between interarterial and septal subtypes of anomalous left coronary arteries (CAs). OBJECTIVE: We compared the classification of anomalous left CA arising from the right sinus of Valsalva (RSV) or right CA on the basis of multidetector computed tomography coronary angiography (MDCTCA) with the classification derived from CCA. METHODS: A retrospective review of 6000 consecutive electrocardiographic-gated MDCTCAs identified 15 cases of anomalous left main or left anterior descending CA arising from the RSV or right CA coursing between the aorta and the main pulmonary artery. On the basis of MDCTCA findings, the proximal course of each vessel was classified into 3 subtypes: 1, interarterial; 2, septal; and 3, mixed. CCA was reviewed in 5 cases (33%) and classified according to traditional criteria. When CCA images were not available, 3-dimensional volume-rendered reconstructions were used to simulate CCA. RESULTS: On the basis of MDCTCA, subtypes were distributed as type 1 (n = 2), type 2 (n = 4), and type 3 (n = 8). One case could not be classified into any of these subtypes and was classified as type 4, right ventricular infundibulum (RVI). Applying CCA criteria, 2 cases would have been classified as interarterial and 14 as septal without appreciation of the mixed or RVI subtypes. CONCLUSIONS: Classification of anomalous left CAs into either septal or interarterial may be too simplistic. There is an anatomic spectrum of anomalous left CAs detected by MDCTCA that challenges the traditional classification based on CCA.
Felipe S Torres; Elsie T Nguyen; Carole J Dennie; Andrew M Crean; Eric Horlick; Mark D Osten; Narinder Paul
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Publication Detail:
Type:  Comment; Comparative Study; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2010-04-11
Journal Detail:
Title:  Journal of cardiovascular computed tomography     Volume:  4     ISSN:  1876-861X     ISO Abbreviation:  J Cardiovasc Comput Tomogr     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-06-28     Completed Date:  2010-10-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101308347     Medline TA:  J Cardiovasc Comput Tomogr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  246-54     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
Department of Medical Imaging, Division of Cardiothoracic Imaging, Toronto General Hospital, University of Toronto, University Health Network, Mount Sinai Hospital, Toronto, ON, Canada.
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MeSH Terms
Coronary Angiography / methods*
Coronary Vessel Anomalies / classification,  radiography*
Heart Septum / radiography
Middle Aged
Predictive Value of Tests
Pulmonary Artery / radiography
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Sinus of Valsalva / abnormalities,  radiography
Terminology as Topic
Tomography, X-Ray Computed*
Comment On:
J Cardiovasc Comput Tomogr. 2010 Jul-Aug;4(4):255-7   [PMID:  20579616 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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