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Coronary arterioluminal communications in routine angiography
D Elian1, Y H Zahav, O Agranat
1Heart Institute, Sheba Medical Center, Tel-Hashomer, and Tel Aviv University, Israel.
Insights
Coronary angiography rarely shows left ventricular cavity visualization via arterioluminal communications. These findings in 14 patients with angina suggest a steal phenomenon may cause myocardial ischemia.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Coronary angiography is standard for diagnosing coronary artery disease.
- Visualization of the left ventricular cavity from coronary arterioluminal communications is an uncommon finding.
Purpose of the Study:
- To report the incidence and characteristics of coronary arterioluminal communications visualized during coronary angiography.
- To explore the potential link between these communications and myocardial ischemia.
Main Methods:
- Retrospective analysis of 5,500 consecutive cardiac catheterizations.
- Identification and characterization of arterioluminal communications originating from the left anterior descending coronary artery.
Main Results:
- Fourteen cases (0.25%) of coronary arterioluminal communications were identified.
- All 14 patients presented with angina pectoris.
- Two patients showed anterior wall ischemia despite a normal left anterior descending artery.
Conclusions:
- Coronary arterioluminal communications are rare but can be visualized during angiography.
- These findings, particularly from the left anterior descending artery, may be associated with angina and myocardial ischemia.
- A steal phenomenon is hypothesized as a potential cause for ischemia in affected patients.
Abstract:
Visualization of the left ventricular cavity from coronary arterioventricular communications is rarely encountered in routine coronary angiography. We report 14 patients, of 5,500 consecutive cardiac catheterizations, in whom these communications were evident during coronary angiography. All 14 patients had angina pectoris; in each the arterioluminal communication originated from the left anterior descending coronary artery. Two patients had evidence of anterior wall ischemia despite a normal left anterior descending coronary artery, suggesting that a possible steal phenomenon is responsible for the myocardial ischemia.