Author + information
- Christopher Michael Buckley,
- Thomas Rosamond,
- S. Roy Hegde and
- Louis Wetzel
Background: Coronary arteries which course intact and through the cavity of a cardiac chamber then emerge back into the epicardial space have been described as “intra-cavitary” or “intra-cameral” (IC) coronary arteries (ICCA). The IC location of these vessels risks damage during intracardiac procedures. The prevalence and anatomic characteristics of this anomaly are largely unknown. This study reports the prevalence and distribution of ICCA in a large population of consecutive patients studied by coronary computed tomography angiography (CCTA).
Methods: Reports from 7847 consecutive CCTA studies between 2006 and 2016 were searched using proprietary transcription word recognition software for the words “intra-cameral” and “intra-cavitary”. The medical records and images were reviewed. The artery, course, and length of the IC segments were recorded and analyzed.
Results: 28 patients with ICCA were identified (mean age 59.8+/-15.9, 95% CI 53.7-66.0, 57.1% male, 42.9% female). None of the identified patients had additional coronary anomalies. 17 cases involved the right coronary artery (RCA) coursing through the right atrium. 11 cases involved the left anterior descending coronary artery (LAD) coursing through the right ventricle. The prevalence of ICCA was 0.36%; 0.22% and 0.14% for the RCA and the LAD respectively. Mean IC length was 27.8+/- 16.6 mm, 95% CI 21.4-34.3; 35.8 mm and 15.6 mm for the RCA and the LAD respectively. Two cases were identified which were suspicious but not conclusive for ICCA of the left circumflex coronary artery.
Conclusions: ICCA is a rare isolated anomaly most commonly involving the RCA coursing through the right atrial cavity, less commonly involving the LAD coursing through the right ventricular cavity. ICCA of the RCA tends to involve longer IC segments in comparison to ICCA of the LAD. While usually clinically silent, it has the potential for catastrophic complications in patients undergoing intracardiac procedures. CCTA is likely the only modality capable of characterizing ICCA prior to invasive procedures, and ICCA is likely underreported because of unawareness of the condition.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Non Invasive Imaging: Applications in Novel Disease States and Clinical Scenarios
Abstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT Angiography
Presentation Number: 1117-205
- 2017 American College of Cardiology Foundation