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Anomalous origin of the three coronary arteries from the right aortic sinus Valsalva: Role of MDCT coronary angiography

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Abstract

Background

Monocuspal origin of all three coronary arteries through separate ostia from the right aortic sinus (RCS) is a rare occurrence. To date, the use of multidetector computed tomography (MDCT) for imaging of congenitally abnormal coronary arteries has been discussed only in few individual case reports.

Objective

To describe the role of MDCT coronary angiography in the evaluation of two rare cases of monocuspal origin of all three coronary from RCS.

Patients and methods

We had a retrospective review of clinical information and imaging studies for two patients presented with chest pain. Both patients underwent conventional coronary angiography followed by noninvasive imaging with MDCT.

Results

Both patients had anomalous origin of the all three coronary arteries from the RCS. In one case the LAD took an intramural course in between the aorta and the right ventricular outflow tract (RVOT) while it passed anterior to the RVOT in the other patient. In the first patient, there was also associated coronary fistula to the right ventricle along with right coronary artery (RCA) and left anterior descending coronary artery (LAD) narrowing. Both the stenosed segments were successfully stented and were demonstrated to be patent in the subsequent MDCT.

Conclusion

Monocuspal origin of all three coronary artery from the RCS is a rare anomaly, can be reliably diagnosed by MDCT. CT angiogram is a convenient complementary tool for the coronary arteriography

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Abbreviations

AMI:

acute myocardial infarction

CAD:

Coronary artery disease

CAF:

coronary artery fistula

LAD:

left anterior descending coronary artery

LCX:

left circumflex coronary artery

MIP:

maximum intensity projection

MDCT:

Multidetector row computed tomography

ROC:

right aortic sinus of Valsalva

RCA:

right coronary artery

RCS:

right coronary aortic sinus

RVOT:

right ventricular outflow tract

VRT:

volume rendering technique

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Authors and Affiliations

  1. Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation and Hamad General Hospital, Doha, Qatar

    Ayman A. El-Menyar & Jassim Al-Suwaidi

  2. Department of Radiology, Hamad Medical Corporation, Doha, Qatar

    K.M. Das

  3. Department of Cardiology and Cardiovascular Surgery, Hamad Medical Corporation and Hamad General Hospital, 3050, Doha, State of Qatar

    Jassim Al-Suwaidi

Authors
  1. Ayman A. El-Menyar
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  2. K.M. Das
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  3. Jassim Al-Suwaidi
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Correspondence to Jassim Al-Suwaidi.

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El-Menyar, A.A., Das, K. & Al-Suwaidi, J. Anomalous origin of the three coronary arteries from the right aortic sinus Valsalva: Role of MDCT coronary angiography. Int J Cardiovasc Imaging 22, 723–729 (2006). https://doi.org/10.1007/s10554-005-9062-7

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  • DOI: https://doi.org/10.1007/s10554-005-9062-7

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