Related Experiment Video
Updated: Dec 20, 2025
Evaluation of a Novel Laser-assisted Coronary Anastomotic Connector - the Trinity Clip - in a Porcine Off-pump Bypass Model
Published on: November 24, 2014
Assessment of Anomalous Coronary Arteries by Imagers and Surgeons: Comparison of Imaging Modalities
Kanwal M Farooqi1, Shannon N Nees1, Jennifer Smerling1
1Division of Cardiology, Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.
Insights
Three-dimensional (3D) models offer superior assessment of anomalous aortic origin of a coronary artery (AAOCA) compared to traditional 2D echocardiograms and CT scans. Specialists accurately evaluated AAOCA characteristics using 3D models and CT, improving diagnostic precision for this condition linked to sudden cardiac death.
Area of Science:
- Cardiology
- Medical Imaging
- Congenital Heart Disease
Background:
- Anomalous aortic origin of a coronary artery (AAOCA) is a critical condition associated with sudden cardiac death.
- Current high-risk characteristic assessment relies on 2D echocardiography (echo) and cardiac computed tomography (CT).
- The study investigates the potential of 3D digital models for improved AAOCA assessment.
Purpose of the Study:
- To evaluate the accuracy of 3D digital models in assessing high-risk characteristics of anomalous aortic origin of a coronary artery (AAOCA).
- To compare the diagnostic performance of 3D models with traditional 2D echo and CT imaging modalities.
- To determine the preferred imaging modality for specialists in evaluating AAOCA.
Main Methods:
- Six patients with repaired AAOCA provided imaging data (echo, CT, 3D model).
- Fourteen cardiothoracic surgeons and cardiac imaging specialists assessed the image representations.
- Assessment accuracy was benchmarked against operative findings.
Main Results:
- 3D models and CT demonstrated higher accuracy in identifying AAOCA type and course compared to echo.
- 3D models showed superior accuracy for ostial characteristics, including stenosis and separate ostium assessment.
- Intramurality assessment accuracy remained low across all modalities.
Conclusions:
- Cardiac CT and 3D models provide more accurate assessments of AAOCA presence, type, and course than echo.
- 3D models excel in depicting ostial features, crucial for surgical planning.
- Specialists across disciplines benefit from the enhanced visualization offered by CT and 3D models for AAOCA evaluation.
Background:
Anomalous aortic origin of a coronary artery (AAOCA) is associated with sudden cardiac death. High-risk characteristics are most commonly assessed using a 2-dimensional (2D) echocardiogram (echo) or cardiac computed tomography (CT). We hypothesize that these characteristics will be more accurately assessed when they are presented in the form of a 3D digital model.
Methods:
Fourteen participants, including cardiothoracic surgeons and cardiac imaging specialists, assessed image representations, including echo, CT images, and a 3D digital model, from 6 patients who had undergone AAOCA repair. Accuracy of assessment was evaluated by comparing responses with operative findings (the gold standard).
Results:
The reported type of AAOCA was most accurately assessed on CT (100%) and 3D models (92.31%) compared with echo (80.77%). The accuracy of the AAOCA course was highest on CT (91.03%), followed by the 3D model (80.77%), and lowest on echo (61.54%). The accuracy of intramurality was low across all imaging modalities (17.95% echo, 29.49% CT, and 21.79% 3D model). Accurate assessment of a separate AAOCA ostium was highest on 3D models (97.40%). Ostial stenosis was more accurately assessed on 3D models (56.41%). When accuracy was separated by subspecialty, CT and 3D models were more accurately assessed by all participants regardless of training.
Conclusions:
Cardiac imagers and congenital cardiothoracic surgeons most accurately assessed AAOCA presence, type, and course on cardiac CT and 3D models. 3D models were superior in representation of ostial characteristics. CT and 3D models are overall more accurately assessed by specialists regardless of training.
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:20Imaging Studies for Cardiovascular System III: X-Ray
Definition and Purpose
An X-ray, or radiograph, is a non-invasive method that uses ionizing radiation to take images of internal structures. It is mainly used in cardiac imaging to examine the heart, lungs, and major blood vessels, aiming to identify abnormalities in the heart's size, shape, and position, such as heart failure, congenital defects, and vascular...
01:20Imaging Studies for Cardiovascular System II:Types of Echocardiography
Types of Echocardiography
Transthoracic Echocardiography (TTE)
TTE is the most common type of echocardiogram which involves placing a transducer on the patient's chest, emitting sound waves to create heart images. TTE is invaluable for evaluating the heart's size, structure, and motion, making it particularly useful for...
01:17Imaging Studies for Cardiovascular System I:Echocardiography
Indications: Echocardiography is utilized to diagnose heart failure, valve disorders, and myocardial infarction. It also assesses cardiac structures' size, shape, and motion,...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT