CTA in diagnosis of anomalous origin of coronary artery from pulmonary artery / 中国医学影像技术

ABSTRACT

Objective To evaluate CTA characteristics of anomalous origin of coronary artery from the pulmonary artery (ACAPA).Methods The clinical data of 24 patients with ACAPA were retrospectively analyzed,and the results of CTA were compared with operation.Results In 24 ACAPA cases,20 cases (20/24,83.33％) occurred in the left coronary artery (LCA),1 case (1/24,4.17％) was in the right coronary artery (RCA),1 case (1/24,4.17％) was in the anterior descending artery (LAD) and 2 cases (2/24,8.33 ％) were in the circumflex artery (LCX).The origins of coronary anomalies originated from the posterior wall of the pulmonary sinus or pulmonary trunk in 11 cases (11/24,45.83 ％),left wall in 7 cases (7/24,29.17％),right wall in 4 cases (4/24,16.67％),originated in the left pulmonary artery in 2 cases (2/24,8.33％).Collateral circulation:Infant type was in 5 cases,no collateral vessels between the coronary artery was observed;adult type was in 19 cases,of which 16 cases were of abnormal origin of the LCA and RCA,1 case was of LAD,2 cases were of LCX.The double LAD and coronary arteries with an intramural segment were found in 1 case respectively.Surgery were performed in 19 cases.Five cases were reviewed by CTA,1 case with anastomotic stenosis of LCX,1 case with restenosis of right ventricular outflow tract and 1 case with coronary pseudoaneurysm.Conclusion CTA can clearly show the origin of abnormal coronary artery,the distance from the ascending aorta,collateral vessels,combined with other coronary artery malformations,which can help surgical preparation of preoperative surgical approach,and postoperative follow-up.