Author + information
- Chance M. Witt,
- Leslie Elvert,
- Ewa Konik,
- Naser Ammash,
- David Foley and
- Thomas Foley
Background: An unrecognized tubular structure was noted on the transthoracic echocardiogram (TTE) of several patients (image, panels A and C). This appeared to correlate with a retroaortic anomalous coronary artery identified on a patient's computed tomography (CT) study (image, panels B, D and E). We aimed to determine if this sign on TTE (panel A) was consistently associated with this coronary anomaly.
Methods: Adult patients with a retroaortic anomalous coronary on CT who also had a TTE from 2005-2015 were included. A matched control group with normal coronary arteries on CT was identified. TTE from both groups were reviewed by blinded investigators who indicated the presence of the sign in question, dubbed the RAC sign. These results were compared to the known coronary anatomy.
Results: There were 49 patients with the anomaly on CT matched with 49 patients with no coronary anomalies. In patients with an anomaly, the RAC sign was present in 31 echocardiograms (63%) compared to its presence in only 3 patients (6%) with normal coronaries (p < 0.001). Thus, the RAC sign has a sensitivity of 63.3% and specificity of 93.9% for indicating the presence of a retroaortic anomalous coronary artery. Only 1 (2.0%) clinical TTE report noted the presence of a coronary anomaly.
Conclusions: The RAC sign is highly specific for the presence of a retroaortic anomalous coronary artery. Due to the potential for adverse events associated with the anomaly, this sign should not be dismissed as artifact, as may have occurred previously.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Things That Begin With an “A” in Adult Congenital Heart Disease: What Is Aorta, Artery and Anomalous?
Abstract Category: 9. Congenital Heart Disease: Adult
Presentation Number: 1232-024
- 2017 American College of Cardiology Foundation