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.
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Article Info
Publication History
Published online: February 13, 2013
Accepted:
January 2,
2013
Received in revised form:
January 2,
2013
Received:
September 28,
2012
Footnotes
See page 1367 for disclosure information.
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Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
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- What Is in a Name? The Need for Strict Diagnostic Criteria in Computerized Tomographic Angiography of Anomalous Coronary Artery Originating From the Opposite Aortic SinusAmerican Journal of CardiologyVol. 111Issue 11
