Anomalous right coronary artery arising next to the left coronary ostium: unambiguous detection of the anatomy by computed tomography and evaluation of functional significance by cardiovascular magnetic resonance.
Herein we report on the diagnostic potential of multi-detector row computed tomography (MDCT) combined with cardiovascular magnetic resonance (CMR) for the diagnostic workup in an adult patient with a rare coronary anomaly. MDCT unambiguously detected the anomalous right coronary artery (RCA), which originated next to the left coronary ostium and coursed inter-arterially between the ascending aorta and the pulmonary trunk. The intramural proximal intussusception of the ectopic RCA could be clearly appreciated on MDCT images, while multiple mixed plaques were detected in the left anterior descending (LAD), resulting in moderate stenosis of this vessel. CMR during adenosine infusion ruled-out inducible ischemia, yielding normal perfusion patterns both in the RCA and in the LAD coronary territory. Since ischemia was not demonstrated by stress CMR, revascularization was not performed.
Korosoglou
Grigorios
G
Department of Cardiology, University of Heidelberg, Heidelberg, Germany. Electronic address: Grigorios.Korosoglou@med.uni-heidelberg.de.
Heye
Tobias
T
Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
Giannitsis
Evangelos
E
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
Hosch
Waldemar
W
Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
Kauczor
Hans U
HU
Department of Diagnostic and Interventional Radiology, University of Heidelberg, Heidelberg, Germany.
Katus
Hugo A
HA
Department of Cardiology, University of Heidelberg, Heidelberg, Germany.
D000369:Aged, 80 and over; D017023:Coronary Angiography / Q000379:methods; D003330:Coronary Vessel Anomalies / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003331:Coronary Vessels; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D014057:Tomography, X-Ray Computed / Q000379:methods