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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.
Catheterization and Cardiovascular Diagnosis
|February 24, 1998
Summary
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.