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Current Cardiology Reports
Published in: Current Cardiology Reports 5/2017

01-05-2017 | Congenital Heart Disease (RA Krasuski, Section Editor)

Coronary Artery Anomalies: When You Need to Worry

Authors: Ajar Kochar, Todd Kiefer

Published in: Current Cardiology Reports | Issue 5/2017

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Abstract

Purpose of Review

There is a broad spectrum of coronary artery anomalies that cardiologists may encounter either incidentally or during evaluation for cardiac symptoms. These anomalies include anomalous coronary arteries arising from the opposite sinus of Valsalva (ACAOS), coronary fistulae, and coronary artery aneurysms. This manuscript outlines the unique features, diagnostic characteristics, and treatment considerations for these lesions.

Recent Findings

Intravenous ultrasound (IVUS), computed tomographic angiography (CTA), and magnetic resonance imaging (MRI) are becoming more sophisticated and will be increasingly used to facilitate the optimal treatment approach for coronary anomalies.

Summary

There are a wide variety of coronary artery anomalies and their clinical ramifications range from benign to potentially fatal. Coronary anomalies often have complex anatomy and require advanced imaging modalities for comprehensive characterization. Due to the heterogeneity in lesion characteristics and outcomes, physicians should consider clinical and imaging features to create individualized management plans, along with referral to adult congenital heart disease centers.
Literature
1.
Krasuski RA, et al. Long-term outcome and impact of surgery on adults with coronary arteries originating from the opposite coronary cusp. Circulation. 2011;123(2):154–62.CrossRefPubMed
2.
3.
Eckart RE, et al. Sudden death in young adults: a 25-year review of autopsies in military recruits. Ann Intern Med. 2004;141(11):829–34.CrossRefPubMed
4.
Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol. 1992;20(3):640–7.CrossRefPubMed
5.
Angelini P. Coronary artery anomalies: an entity in search of an identity. Circulation. 2007;115(10):1296–305.PubMed
6.
Warnes CA, et al. ACC/AHA 2008 Guidelines for the Management of Adults with Congenital Heart Disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to develop guidelines on the management of adults with congenital heart disease). Circulation. 2008;118(23):e714–833.CrossRefPubMed
7.
• Angelini P. Novel imaging of coronary artery anomalies to assess their prevalence, the causes of clinical symptoms, and the risk of sudden cardiac death. Circ Cardiovasc Imaging. 2014;7(4):747–54. This paper highlights the role of novel imaging tools such as magnetic resonance angiography, computed tomography angiography, and optical coherence tomography in diagnosing and risk stratifying patients with coronary artery anomalies CrossRefPubMed
8.
•• Van Hare GF, et al. Eligibility and disqualification recommendations for competitive athletes with cardiovascular abnormalities: task force 4: congenital heart disease: a scientific statement from the American Heart Association and American College of Cardiology. J Am Coll Cardiol. 2015;66(21):2372–84. This paper establishes guideline recommendations regarding optimal care for trained athletes with cardiac disease CrossRefPubMed
9.
Fedoruk LM, et al. Anomalous origin of the right coronary artery: right internal thoracic artery to right coronary artery bypass is not the answer. J Thorac Cardiovasc Surg. 2007;133(2):456–60.CrossRefPubMed
10.
Poynter JA, et al. Anomalous aortic origin of a coronary artery: a report from the congenital heart surgeons society registry. World J Pediatr Congenit Heart Surg. 2014a;5(1):22–30.CrossRefPubMed
11.
Poynter JA, et al. Repair of anomalous aortic origin of a coronary artery in 113 patients: a Congenital Heart Surgeons’ Society report. World J Pediatr Congenit Heart Surg. 2014b;5(4):507–14.CrossRefPubMed
12.
Frommelt PC, et al. Prospective echocardiographic diagnosis and surgical repair of anomalous origin of a coronary artery from the opposite sinus with an interarterial course. J Am Coll Cardiol. 2003;42(1):148–54.CrossRefPubMed
13.
14.
15.
Sorajja P, et al. Myocardial bridging in adult patients with hypertrophic cardiomyopathy. J Am Coll Cardiol. 2003;42(5):889–94.CrossRefPubMed
16.
Kiefer TL, et al. Coronary arteriovenous fistulae: the complexity of coronary artery-to-coronary sinus connections. Tex Heart Inst J. 2012;39(2):218–22.PubMedPubMedCentral
17.
18.
Valente AM, et al. Predictors of long-term adverse outcomes in patients with congenital coronary artery fistulae. Circ Cardiovasc Interv. 2010;3(2):134–9.CrossRefPubMed
19.
Brotherton H, Philip RK. Anomalous left coronary artery from pulmonary artery (ALCAPA) in infants: a 5-year review in a defined birth cohort. Eur J Pediatr. 2008;167(1):43–6.CrossRefPubMed
20.
Williams IA, Gersony WM, Hellenbrand WE. Anomalous right coronary artery arising from the pulmonary artery: a report of 7 cases and a review of the literature. Am Heart J. 2006;152(5):1004.e9–17.CrossRef
21.
22.
Aoki J, et al. Coronary artery aneurysms after drug-eluting stent implantation. JACC Cardiovasc Interv. 2008;1(1):14–21.CrossRefPubMed
23.
Satran A, et al. Increased prevalence of coronary artery aneurysms among cocaine users. Circulation. 2005;111(19):2424–9.CrossRefPubMed
24.
25.
Newburger JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the committee on rheumatic fever, endocarditis and Kawasaki disease, council on cardiovascular disease in the young, American Heart Association. Circulation. 2004;110(17):2747–71.CrossRefPubMed
26.
27.
Ruzmetov M, et al. Repair of tetralogy of Fallot with anomalous coronary arteries coursing across the obstructed right ventricular outflow tract. Pediatr Cardiol. 2005;26(5):537–42.CrossRefPubMed
28.
Gupta D, et al. Detection of coronary artery anomalies in tetralogy of Fallot using a specific angiographic protocol. Am J Cardiol. 2001;87(2):241–4. A9 CrossRefPubMed
29.
Brown JW, et al. Surgical repair of congenital supravalvular aortic stenosis in children. Eur J Cardiothorac Surg. 2002;21(1):50–6.CrossRefPubMed
Metadata
Title
Coronary Artery Anomalies: When You Need to Worry
Authors
Ajar Kochar
Todd Kiefer
Publication date
01-05-2017
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 5/2017
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-017-0854-x

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