640-SLICE CT CORONARY ANGIOGRAPHY IN THE EARLY POSTOPERATIVE PERIOD AFTER CIRCUMFLEX ARTERY STENTING IN A PATIENT WITH ANOMALOUS ORIGIN OF THE RIGHT CORONARY ARTERY FROM THE LEFT SINUS OF VALSALVA

The paper describes a clinical observation showing the capabilities of three-dimensional dynamic 640-slice CT coronary angiography in the postoperative period after coronary artery stenting and in the presence of anomalous origin of coronary arteries from a single coronary sinus. Patient K. aged 76 years who had sought medical advice for his complaints of pressing retrosternal pain radiating to the inter-scapular region when walking 20–30 meters, as well as intermittent episodes of crushing pain at rest was examined. The patient underwent coronary angiography, circumflex artery stenting, and three-dimensional dynamic 640-slice CT-coronary angiography in the early postoperative period. Three-dimensional dynamic 640-slice CT coronary angiography after circumflex artery stenting could determine the status of the operated artery and stent and identify a variant of anomalous origin of the right coronary artery, which had not been previously diagnosed using two invasive coronary angiographies. 

1. Angelini P., Velasco J.A., Flamm S. Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation. 2002; 105: 2449–54.

2. Shi H., Aschoff A.J., Brambs H.J., Hoffmann M.H. Multislice CT imaging of anomalous coronary arteries. Eur. Radiol. 2004; 14: 2172–81.

3. Терновой С.К., Никонова М.Э., Акчурин Р.С., Федотенков И.С., Ширяев А.А. Возможности мульти-спиральной компьютерной томографии (МСКТ) в оценке коронарного русла и вентрикулографии в сравнении с интервенционной коронаровентрикулографией. Российский электронный журнал лучевой диагностики. 2013; 3 (1): 28–35. [Ternovoy S.K., Nikonova M.E., Akchurin R.S., Fedotenkov I.S., Shiryaev A.A. Capabilities of multislice computed tomography in the evaluation of coronary arteries and ventriculography versus interventional coronary and ventriculography. Rossiyskiy Elektronnyy Zhurnal Luchevoy Diagnostiki (Russian Electronic Journal of Radiology (REJR)). 2013; 3 (1): 28–35 (in Russ.).]

4. Villa A.D., Sammut E., Nair A., Rajani R., Bonamini R., Chiribiri A. Coronary artery anomalies overview: the normal and the abnormal. World J. Radiol. 2016; 8 (6): 537–55.

5. Jim M.H., Siu C.W., Ho H.H., Miu R., Lee S.W. Anomalous origin of the right coronary artery from the left coronary sinus is associated with early development of coronary artery disease. J. Invasive Cardiol. 2004; 16: 466–8.

6. Cheezum M.K., Ghoshhajra B., Bittencourt M.S., Hulten E.A., Bhatt A., Mousavi N. et al. Anomalous origin of the coronary artery arising from the opposite sinus: prevalence and outcomes in patients undergoing coronary CTA. Eur. Heart J. Cardiovasc. Imag. 2017; 18 (2): 224–35.

7. Barriales-Villa R., Morís C., Sanmartín J.C., Fernández E., Pajín F., Ruiz Nodar J.M. Anomalous coronary arteries originating in the con-tralateral sinus of Valsalva: registry of thirteen Spanish hospitals (RACES). Rev. Esp. Cardiol. 2006; 59 (6): 620–3 (in Spain).