Aim: We investigated the potential of dual source computed tomography for non-invasive evaluation of coronary artery anomalies. Methods: Patients with anomalous origin of a coronary artery from the opposite sinus of Valsalva, rotation of the aortic root and coronary artery fistula were selected from a total of 680 individuals examined with dual source computed tomography including thin MIP, MPR and VR post-processing. Images were reconstructed with a slice thickness of 0.6 mm using retrospective ECG-gated reconstruction. The selected data sets were analysed with respect to the origin, course and termination of the coronary artery anomalies.
Results: A total of 11 patients (7 men, 4 women, 33-76 years) with anomalous coronary arteries were identified. The incidence of anomalous coronary arteries was 1.62% (11/680). The origins and course were clearly visualized in all patients, including right-sided origin of the left main (n=2) and left circumflex (n=3) arteries; left-sided origin of the right coronary artery (n=3); rotation of the aortic root (n=2) and one coronary fistula from the left circumflex to the right atrium. All patients with right-sided origin of the left main and left-sided origin of the right coronary artery (n=5) showed an interarterial course and 3 were judged as ‘malignant’ because of the significant compression between the aortic root and the pulmonary trunk. Four out of 11 patients (36.4%) with coronary anomalies were referred for computed tomography due to non-selective cannulation in coronary angiography.
Conclusions: This study demonstrates that dual source computed tomography is an accurate and non-invasive technique to identify and define the course of anomalous coronary arteries.