Anomalous origin of the left coronary artery from the pulmonary artery in children: diagnostic use of multidetector computed tomography

• Published in: Pediatric radiology Vol. 46; no. 10; pp. 1392 - 1398
• Main Authors: Shen, Quanli, Yao, Qiong, Hu, Xihong
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.09.2016; Springer Nature B.V
• Subjects: Child; Child, Preschool; Coronary Angiography; Coronary Vessel Anomalies - diagnostic imaging; Coronary Vessel Anomalies - surgery; Echocardiography; Female; Humans; Imaging; Infant; Male; Medicine; Medicine & Public Health; Multidetector Computed Tomography; Neuroradiology; Nuclear Medicine; Oncology; Original Article; Pediatrics; Pulmonary Artery - abnormalities; Radiology; Retrospective Studies; Ultrasound; Coronary angiography; Congenital anomaly; Children; Computed tomography; Coronary artery
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s00247-016-3635-6

Background Anomalous origin of the left coronary artery from the pulmonary artery is a rare congenital anomaly. It is important to demonstrate the anomalous origin of the left coronary artery and its course before surgery. Objective To explore the clinical diagnostic use of multidetector CT coronary angiography in detecting anomalous origin of the left coronary artery from the pulmonary artery in children. Materials and methods Nine children (2 boys, 7 girls) ages 2 months to 9 years with surgically confirmed anomalous origin of the left coronary artery from the pulmonary artery were studied. Clinical data, transthoracic echocardiography and CT coronary angiography images were retrospectively analyzed. Results Transthoracic echocardiography correctly diagnosed anomalous origin of the left coronary artery from the pulmonary artery in 7 of 9 patients (95% CI: 40–97%). CT coronary angiography revealed the anomalous origin of the left coronary artery in all children (95% CI: 66–100%). In a 4-year-old girl and a 9-year-old girl, CT coronary angiography showed dilation of the right coronary artery and collateral circulation between the right and the left coronary arteries. Conclusion CT coronary angiography is a useful method to show the anomalous origin of the coronary artery in children with anomalous origin of the left coronary artery from the pulmonary artery, especially for patients in whom origin of the left coronary artery cannot be detected by transthoracic echocardiography.