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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Coronary Artery Variants and Anomalies in Patients With Bicuspid Aortic Valve

Ilona M Michałowska1, Tomasz Hryniewiecki, Paweł Kwiatek

  • 1Departments of *Radiology †Heart Valve Diseases, Institute of Cardiology ‡Foreign Languages Department, Medical University of Warsaw, Warsaw; Poland.

Journal of Thoracic Imaging
|April 5, 2016
PubMed

Insights

Patients with bicuspid aortic valve (BAV) show similar coronary artery anomaly rates but differences in left main coronary artery (LMCA) length and branching patterns compared to tricuspid aortic valve (TAV) patients.

Area of Science:

  • Cardiovascular Imaging
  • Cardiac Anatomy
  • Congenital Heart Disease

Background:

  • Bicuspid aortic valve (BAV) is a common congenital heart defect.
  • Associated cardiovascular anomalies are frequent in BAV patients.
  • Coronary artery variations may impact surgical and interventional procedures.

Purpose of the Study:

  • To investigate the prevalence of coronary artery variants and anomalies in patients with BAV.
  • To compare coronary artery patterns between patients with BAV and tricuspid aortic valve (TAV).

Main Methods:

  • Retrospective analysis of 428 patients undergoing coronary computed tomography angiography.
  • Patients were categorized into BAV (n=193) and TAV (n=235) groups.
  • Detailed assessment of coronary artery dominance, LMCA length, and presence of specific anomalies.

Main Results:

  • No significant difference in overall coronary artery anomaly prevalence between BAV and TAV groups (P=0.5).
  • Patients with BAV showed a significantly shorter mean left main coronary artery (LMCA) length (10.45±6.93 mm vs 12.02±5.12 mm, P=0.008).
  • Absence of LMCA with separate origins was more frequent in BAV (7.3%) than TAV (1.7%) (P=0.004); ramus intermedius was also more common in BAV (15%) vs TAV (8.9%) (P=0.05).

Conclusions:

  • Overall coronary artery anomaly rates are similar between BAV and TAV.
  • BAV is associated with a higher incidence of LMCA absence and ramus intermedius presence.
  • Shorter LMCA length in BAV patients warrants consideration in clinical practice.
Abstract

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