title: Prevalence and characteristics of coronary anomalies originating from the opposite sinus of Valsalva in 8,522 patients referred for coronary computed tomography angiography.
abstract: Although coronary computed tomographic angiography has the ability to depict potentially malignant features of anomalous coronary artery originating from the opposite sinus of Valsalva (ACAOS), there are limited data on the significance of ACAOS in the computed tomography population. The aims of this study were to assess the prevalence of ACAOS and to correlate its anatomic features with patients' symptoms among 8,522 consecutive subjects who underwent coronary computed tomographic angiography from February 2008 to May 2012. The ACAOS proximal course was classified into anterior, interarterial, septal, and retroaortic subtypes. Malignant ACAOS was recorded if a slitlike ostium, an acute angle of takeoff, an intramural course, and significant compression between the aorta and pulmonary trunk were present simultaneously. The prevalence of ACAOS was 0.84% (72 of 8,522), including right-sided origins of the left main coronary artery (n = 11), left anterior descending coronary artery (n = 9), and left circumflex coronary artery (n = 33) and left-sided origin of the right coronary artery (n = 20). Of the 24 ACAOS (0.28%) with an interarterial course, 12 (0.14%) showed significant vessel compression, of which 6 (0.07%) were classified as malignant. The presence of significant interarterial compression and malignant ACAOS type were observed in left-sided right coronary arteries only, and interarterial compression correlated with patients' symptoms at a median of 15-month follow-up. In conclusion, the computed tomographic prevalence of ACAOS seems to be comparable with that of previous angiographic studies. The malignant features of ACAOS in the adult computed tomography population might be exclusively associated with left-sided right coronary arteries.
authors: Institute of Cardiology, Warsaw, Poland. maxopol@gmail.com
authors: Maksymilian P
authors: MP
authors: Opolski
authors: Jerzy
authors: J
authors: Pregowski
authors: Mariusz
authors: M
authors: Kruk
authors: Adam
authors: A
authors: Witkowski
authors: Sonia
authors: S
authors: Kwiecinska
authors: Ewa
authors: E
authors: Lubienska
authors: Marcin
authors: M
authors: Demkow
authors: Tomasz
authors: T
authors: Hryniewiecki
authors: Piotr
authors: P
authors: Michalek
authors: Witold
authors: W
authors: Ruzyllo
authors: Cezary
authors: C
authors: Kepka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D017023:Coronary Angiography / Q000379:methods*; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000000981:diagnostic imaging; D012372:ROC Curve; D012017:Referral and Consultation; D012189:Retrospective Studies; D012850:Sinus of Valsalva / Q000002:abnormalities* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult