OBJECTIVES Coronary artery anomalies (CAA) can be detected by multidetector computed tomography (MDCT) with a high accuracy. The purpose of this study was to evaluate the prevalence of CAA in subjects undergoing MSCT coronary angiography for the assessment of coronary artery disease. STUDY DESIGN This retrospective study included 1,056 patients (534 males, 522 females; mean age 58.8±11.5 years) who underwent coronary dual-source 64-slice MDCT for the assessment of coronary artery disease. Coronary angiographic scans were obtained with injection of 80 ml nonionic contrast medium. Retrospective gating technique was used to synchronize data reconstruction with the ECG signal. The reconstructions were obtained in all cardiac phases at 50-millisecond intervals at a slice thickness of 0.75 mm and a reconstruction increment of 0.5 mm. Maximum intensity projection, multiplanar reformatted, and volume rendering images were derived from axial scans. RESULTS Eleven patients (1.04%) were found to have a CAA. These included high take-off of the left main coronary artery (LMCA) (n=3, 0.3%), absence of the LMCA (n=3, 0.3%), coronary fistula (n=2, 0.2%), right-sided origin of the circumflex artery (n=2, 0.2%), and left anterior descending artery originating from the right coronary artery (n=1, 0.1%). CONCLUSION Multidetector computed tomography is a reliable and useful noninvasive method to identify and define anomalous coronary arteries and their course and can be used as the first-line diagnostic tool in the evaluation of CAAs.

The prevalence of coronary artery anomalies in patients undergoing multidetector computed tomography for the evaluation of coronary artery disease

Amac: Bu calismada 128 kesitli bilgisayarli tomografinin (BT) anatomik koroner arter varyasyonlarini ve anomalilerini saptamadaki etkinligi arastirildi ve elde edilen bulgular literatur verileri ile karsilastirildi. Ca­lis­ma­ pla­ni:­ Subat 2009 Aralik 2010 tarihleri arasinda klinigimizde 128 kesitli BT ile degerlendirilen, supheli veya bilinen koroner arter hastaligi olan 83 hasta (58 erkek, 25 kadin; ort. yas 53.7±10 yil; aralik 31-80 yil) retrospektif olarak incelendi. Tum goruntuler, kardiyovaskuler radyoloji alaninda uzman bir radyolog tarafindan anatomik varyasyon ve anomali acisindan degerlendirildi. Surekli degiskenler aritmetik ortalama ± standart sapma (SS) ile ifade edilirken, kategorik degiskenler yuzde (%) ile ifade edildi. Tanimlayici istatistiksel testler ile istatistiksel analiz yapildi. Bul gu lar: Sag dominans, sol dominans ve kodominans orani sirasiyla %80.7, %8.4 ve %10.8 idi. Konus arterin %16.86 oraninda sag sinus valsalvadan ve %83.1 oraninda sag koroner arterden (sag KA) koken aldigi gozlemlendi. Sinus nod arterin (SNA) %77.1 oraninda sag KA’dan, %18.1 oraninda sirkumfleks (Cx) arterden, %2.4 oraninda sol ana koroner arterden (sol ana KA) ve %2.4 oraninda sag sinus valsalvadan koken aldigi belirlendi. Hastalarin %30.12’sinde ramus intermedius mevcuttu. Kirk sekiz hastada (%57.8) koroner arter anomalisi saptandi. Bu hastalarin %1.2’sinde sol ana KA noksanligi; %6’sinda komissural koken; %1.2’sinde koroner hipoplazi; %4.8’inde kontralateral sinus koken anomalisi ve %43.3’unde miyokard koprusu mevcuttu. So­nuc:­128 kesitli BT, koroner arter varyasyonlarinin ve anomalilerinin saptanmasinda guvenilir, ayrintili ve dogru bilgi saglayan invaziv olmayan bir yontemdir. 128 kesitli BT’nin koroner arter anomalilerinin tani ve cerrahi tedavisinde yuksek oneme sahip oldugu kanisindayiz. Anah tar soz cuk ler: Anjiyografi; anomali; bilgisayarli tomografi; koroner damarlar; tani. Background:­In this study, we aimed to investigate the efficacy of a 128-slice computed tomography (CT) device in detecting anatomical variations and anomalies of coronary arteries and to compare the results obtained with literature data. Methods: Totally, 83 patients (58 males, 25 females; mean age 53.7±10 years; range 31 to 80 years) with suspected or known coronary artery disease who underwent evaluation using the 128-slice CT in our clinic between February 2009 and December 2010 were retrospectively analyzed. All images were evaluated in terms of anatomic variation and anomaly by a radiologist with expertise in cardiovascular radiology. Continuous variables were expressed as arithmetical mean ± standard deviation (SD), while categorical variables were expressed as percent (%). Statistical analysis was performed using descriptive statistical tests. Results:­ The rate of right dominance, left dominance and co-dominance was 80.7%, 8.4% and 10.8%, respectively. It was observed that the conus artery originated from the right sinus valsalva at a rate of 16.86% and from the right coronary artery (RCA) at a rate of 83.1%. It was found that sinus node artery (SNA) originated from the RCA at a rate of 77.1%, from the circumflex (Cx) artery at a rate of 18.1%, from the left main coronary artery (LMCA) at a rate of 2.4% and from the right sinus valsalva at a rate of 2.4%. Ramus intermedius was present in 30.12% of the patients. Coronary artery anomaly was observed in 48 patients (57.8%). of them, 1.2% had absence of LMCA, 6% had commissural origin, 1.2% had coronary hypoplasia, 4.8% had anomalous of contralateral sinus origin, and 43.3% had myocardial bridging. Conclusion:­The 128-slice CT device is a non-invasive method which provides reliable, detailed and correct information for detecting variations and anomalies of coronary arteries. We believe that the 128-slice CT is of higher value in diagnosis and surgical therapy of coronary artery anomalies.

Evaluation of coronary artery anomalies using 128-Slice computed tomography

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare disease characterized by myocardial ischemia which becomes symptomatic shortly after birth leading to left heart failure and death. Survival to adulthood have been reported in some cases. Recognition and diagnosis of ALCAPA syndrome is important due to its potentially life-threatening complications. This case report emphasizes the importance of diagnosing late presentation of the ALCAPA syndrome.

Late presentation of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA): How can clinicians diagnose? -

Presentation of adult Bland–White–Garland syndrome in a 32-year old female

The “single coronary artery” anomaly arises from the aortic root by a single coronary ostium and in the absence of another ostium mostly has an asymptomatic course. However, some types of this congenital anomaly may cause various clinical manifestations like chest pain and even sudden death. In this presentation, a 51-year-old woman, who had complaints of typical chest pain increasing with hypertension was presented. Angiography was performed due to chest pain complaints, revealed that all coronary system was giving off branches from a main single coronary artery, which arose from the right sinus of valsalva. There weren’t any blocking coronary lesions that might cause ischemia. Multislice computed tomography examination was performed in order to describe the symptoms and it was observed that this main coronary artery arose from right sinus of valsalva as well as it followed a retroaortic course. Because of symptoms of myocardial ischemia, further evaluation of the coronary ostium with intravascular ultrasound (IVUS) was suggested. However the patient refused further invasive examination and a medical treatment was arranged. After a month, under a medical treatment and while her blood pressure was under control, she experienced atrial fibrillation attack that had begun after typical chest pain. Medical cardioversion with sotalol was succesfull. At that time further evaluation was again suggested but the patient refused again. The patient having Canadian

https://www.journalagent.com/khj/pdfs/KHJ-20592-CASE_REPORT-AKGULLU.pdf

Single Coronary Artery Anomaly Causing Chest Pain

Koroner Arter Anomalileri

25 Yaş Ve Altında Miyokard İnfarktüsü Geçiren Erkek Hastaların Klinik Ve Laboratuar Özellikleri

Bu çalışma minimal mitral yetmezlik (MY) haricinde sağ­ lıklı kalbi olan kişilerde renkli Doppler ekokardiyografik parametrelerin değerlendirilmesi için yapılmıştır. Çalış­ ma vakaları , 5 aylık bir periyodda, hasta şikayeti ve fiz ik muayene sonucunda ekokardiyografi yapılan 2500 genç erkek vakadan seçildi. Sol ventrikiilografi yapılan vakalar, anjiyografik MY varfığmda grupi (n =30), yoklıığwı­ da grttp-2 (n=30) olarak smıf'andırıldı. Grup-I'deki hastalar \"gerçek MY\", grup-2'deki vakalar ise \"fizyolojik\" olarak adlandtrtldı . Fizyolojik ve gerçek mitral yetmezliğinin Doppler ekokardiyograf ik değişkenleri birbiri ile karşılaştırı ldı . Aşağıdaki ekokardiyografik değişkenler grttp-1 ve grup-2 arasında farklı saptandı . 1) parastemal uzun eksenele maksimum MY siiresilortalama sisrol siiresi (sırasıyla 0.7 10±0.244 ve 0.430±0.268, p<O.OOJ ), 2) apİ­ kal 4 odada maksimum MY siiresilortalanıa sisrol süresi (sırasıyla 0.550±0.361 ve 0.317±0.272 , p=0.007) 3) parasternal ııwn eksenele rejii1 j itan aktm pik hız ı (sırasıyla 180±77 ve 120±69 cm/sn, p=0.003), 4) parastem al uzun eksenele rejiitjitan jet ala111 (sırasıyla 0.813±0.561 ve 0.411 ±431, p=0.007).

Assessment of Doppler Echocardiography in Minimal Mitral Regurgitation: A Comparative Study with Ventriculography

Yaş ortalaması 53,4 7,94 olan toplam 50 hastaya (37 kadın, 13 erkek) günde tek doz Hidroklorotiazid 50 mg+Amilorid HCl 5 mg kombinasyonu verildi. Hastalar­ da anamnezle tespit edilen ortalama hipertansiyon süresi 61,04 ay (0-360 arasında) idi. 15 hasta plasebo grubu olarak çatışmaya katıldı. Sekonder hipertansiyon, serum kreatinin seviyesi, 1,7 mgldl den yüksek olan böbrek bozuk­ luğu olanlar, normalden %30 fazla enzim yüksekliği olan karaciğer hastaları, konjeslif kalp yetmezliği, diabetes mellitus ve plazma renin seviyesi yüksek olanlar çalışmaya alınmadı. Kan tablosu, kolesterol ve serum potasyum seviyelerine olan etkileride değerlendirildi.

Hipertansiyonlu Hastalarda Hidroklorotiazid +Amilorid HCL Kombinasyonunun Etki ve Yan Etkilerinin Değerlendirilmesi

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Koroner Arter Anomalileri

25 Yaş Ve Altında Miyokard İnfarktüsü Geçiren Erkek Hastaların Klinik Ve Laboratuar Özellikleri

Assessment of Doppler Echocardiography in Minimal Mitral Regurgitation: A Comparative Study with Ventriculography

Hipertansiyonlu Hastalarda Hidroklorotiazid +Amilorid HCL Kombinasyonunun Etki ve Yan Etkilerinin Değerlendirilmesi