Title : Anomalous origin of left circumflex artery from right sinus of valsalva in cardiac computed tomography in a group of 16680 patients - radiologic and clinical characteristics
Abstract:
This presentation summarizes the clinical and radiological characteristics of patients with an anomalous origin of the left circumflex artery from the right sinus of Valsalva (RCx), diagnosed by cardiac computed tomography (CT). This anomaly is a rare type of anomalous aortic origin of a coronary artery (AAOCA), and limited data is available on its natural course, effects on myocardial function, and symptoms. The study included 56 cases of RCx from 16,680 CT exams performed in a heart imaging department between 2015 and 2022 (0,33%). The results show that Type I RCx was the most common type of anomaly, occurring in 48% of the patients, followed by Type 2 (25%) and Type 3 (27%). All patients had a "benign" course of the anomalous artery, and the shape of the Cx ostia was predominantly round. The study population consisted of 30 male (54%) and 26 female (46%) patients, and 23% of them had coronary heart disease (CHD). Dyslipidaemia was the most common atherosclerotic risk factor, affecting 30% of the patients, followed by obesity (11%) and type 2 diabetes (13%). Heart failure occurred in 14% of the patients, while atrial fibrillation was diagnosed in 13%. The study findings provide valuable information on the clinical significance of this anomaly and can guide clinical decision-making for affected patients. This is the first study to address this type of lesion in such detail, and the results demonstrate the usefulness of CT imaging in identifying and characterizing this rare anomaly. The authors highlight the need for more research to understand the natural course of RCx and its effect on myocardial function and symptoms, as well as to develop optimal management strategies for affected patients.
Audience Take Away Notes
• The prevalence of this lesion was 0.33%, which is a relatively low occurrence rate. However, it is still necessary to consider this condition during clinical reasoning.
• Type I RCx was the most common type of anomaly, occurring in 48% of the patients.
• All RCx anomalies had a "benign" course, meaning that they did not cause significant harm or danger to the patients.
• Heart failure occurred in only 14% of the patients, indicating that there is no apparent correlation between RCx anomalies and heart failure.
• The preferred method for assessing this type of lesion is CCTA (Coronary Computed Tomography Angiography) as it provides a three-dimensional visualization.
