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Anomalous Coronary Anatomy with Fistula Diagnosed on Coronary Computed Tomography Angiography

Khurram Butt1, Ali Agha2, Ryan Parente3

  • 1Internal Medicine, Florida Hospital, Orlando, USA.

Cureus
|June 28, 2019
PubMed

Insights

This study highlights two rare cases of anomalous coronary arteries in children. Early identification and intervention are crucial for preventing severe cardiac events and sudden cardiac death.

Area of Science:

  • Pediatric Cardiology
  • Congenital Heart Disease
  • Cardiovascular Imaging

Background:

  • Anomalous coronary vasculature is uncommon but can lead to serious adverse events, including sudden cardiac death.
  • Accurate diagnosis of aberrant coronary anatomy is vital for appropriate patient management.
  • This report details two pediatric cases with distinct congenital coronary anomalies.

Observation:

  • Case 1: A 4-year-old male presented with chest pain, revealing anomalous left coronary artery origin from the right sinus with a malignant interarterial course and myocardial bridging.
  • Case 2: A neonate with hypoplastic right ventricle and pulmonary atresia exhibited a coronary sinus fistula and atrial appendage bridge.

Findings:

  • Coronary computed tomography angiography (CCTA) precisely delineated the complex coronary anatomy in both cases.
  • Surgical correction was successful for the patient in Case 1.
  • The infant in Case 2 required transfer for cardiac transplantation due to the complexity of the anomalies.

Implications:

  • These cases underscore the importance of advanced imaging techniques like CCTA in diagnosing rare coronary anomalies.
  • Timely surgical intervention or advanced therapies can improve outcomes in pediatric patients with aberrant coronary arteries.
  • Understanding these rare variations is essential for pediatric cardiac care and research.

Keywords:
anomalous coronary artery

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