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The International Journal of Cardiovascular Imaging

Published in:

01-06-2007 | Original Paper

Multislice computed tomographic findings of the anomalous origins of the right coronary artery: evaluation of possible causes of myocardial ischemia

Authors: Makoto Ichikawa, Yuichi Sato, Sei Komatsu, Atsushi Hirayama, Kazuhisa Kodama, Satoshi Saito

Published in: The International Journal of Cardiovascular Imaging | Issue 3/2007

Abstract

Background

Anomalous right coronary arteries (RCA) arising from the left sinus of Valsalva may cause myocardial ischemia.

Objective

We evaluated morphological features of anomalous RCA by using multislice computed tomography (MSCT) in relation to myocardial ischemia provoked by myocardial perfusion single-photon emission computed tomography.

Methods

MSCT was performed in a total of 3, 212 patients by using an Aquillion 16 and a Light Speed Ultra. Retrospective ECG-gated image reconstruction was performed. Volume rendering, axial and curved multiplanar reformatted images were analyzed for the determination of the origin and course of the RCA, the take-off angle of the RCA from the aorta, and size of the RCA orifice. Furthermore, virtual angioscopic images were also used for the evaluation of the RCA orifice structure.

Results

Anomalous origins of the RCA were found in 15 patients. In 13 patients, the RCA arose from the left sinus of Valsalva, and in 2 patients it arose from the left main coronary artery as a single coronary artery. The RCA coursed anteriorly between the ascending aorta and pulmonary artery in 14 patients, whereas it had a retroaortic course in 1 patient. Acute angle take-off (<30°) of the RCA from the aorta and the left main coronary artery was observed in 8 patients, intramural course of the RCA within the aortic wall was observed in 6 patients and a small RCA orifice was observed in 4 patients. Exercise-induced myocardial ischemia was present in 5 patients.

Conclusion

Coursing between the aorta and pulmonary artery, acute angle take-off and intramural course were thought to be major causes of exercise-induced ischemia in patients with anomalous origins of the RCA.

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Title: Multislice computed tomographic findings of the anomalous origins of the right coronary artery: evaluation of possible causes of myocardial ischemia
Authors: Makoto Ichikawa
Yuichi Sato
Sei Komatsu
Atsushi Hirayama
Kazuhisa Kodama
Satoshi Saito
Publication date: 01-06-2007
Publisher: Kluwer Academic Publishers
Published in: The International Journal of Cardiovascular Imaging / Issue 3/2007
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-006-9165-9

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Multislice computed tomographic findings of the anomalous origins of the right coronary artery: evaluation of possible causes of myocardial ischemia

Abstract

Background

Objective

Methods

Results

Conclusion

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Abstract

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Conclusion

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