title: Congenital coronary artery anomalies silent until geriatric age: non-invasive assessment, angiography tips, and treatment.
abstract: Coronary artery anomalies (CAAs) may be discovered more often as incidental findings during the normal diagnostic process for other cardiac diseases or less frequently on the basis of manifestations of myocardial ischemia. The cardiovascular professional may be involved in their angiographic diagnosis, functional assessment and eventual endovascular treatment. A complete angiographic definition is mandatory in order to understand the functional effects and plan any intervention in CAAs: computed tomography and magnetic resonance imaging are useful non-invasive tools to detect three-dimensional morphology of the anomalies and its relationships with contiguous cardiac structures, whereas coronary arteriography remains the gold standard for a definitive anatomic picture. A practical idea of the possible functional significance is mandatory for deciding how to manage CAAs: non-invasive stress tests and in particular the invasive pharmacological stress tests with or without intravascular ultrasound monitoring can assess correctly the functional significance of the most CAAs. Finally, the knowledge of the particular endovascular techniques and material is of paramount importance for achieving technical and clinical success. CAAs represent a complex issue, which rarely involve the cardiovascular professional at different levels. A timely practical knowledge of the main issues regarding CAAs is important in the management of such entities.
authors: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors: Gianluca
authors: G
authors: Rigatelli
authors: Section of Adult Congenital and Adult Heart Disease, Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.
authors: Fabio
authors: F
authors: Dell'Avvocata
authors: Department of Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam.
authors: Nguyen
authors: N
authors: Van Tan
authors: Brody School of Medicine at East Carolina University, Greenville, North Carolina, USA.
authors: Rames
authors: R
authors: Daggubati
authors: CAMC Vascular Center of Excellence, West Virginia University, Charleston, West Virginia, USA.
authors: Aravinda
authors: A
authors: Nanijundappa
keywords: Congenital heart disease; Coronary artery angiography; Coronary artery anomaly; Percutaneous coronary interventions