State-of-the-Art Review
Catheter Selection and Angiographic Views for Anomalous Coronary Arteries: A Practical Guide

https://doi.org/10.1016/j.jcin.2021.01.054Get rights and content
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Highlights

  • Anomalous aortic origin of coronary artery is associated with sudden cardiac death.

  • Coronary artery anomalies are challenging to selectively engage.

  • The authors summarize the best angiographic views for anomalous vessel course.

  • The authors review catheter selection for selective engagement for each anomaly type.

Abstract

Although congenital coronary artery anomalies are relatively rare, they are the second most common cause of sudden cardiac death among young athletes. When encountered in the cardiac catherization laboratory, they are often challenging to selectively engage, requiring multiple catheters, plus increased contrast volume and radiation exposure. In the setting of acute coronary syndromes, it is not infrequent that percutaneous intervention is delayed because of the inability to engage an anomalous coronary artery. The aim of this review is to provide a comprehensive and concise overview of coronary artery anomalies, with particular attention to diagnostic and guide catheter selection for each type of anomaly and recommendations on how to recognize the vessel course angiographically.

Key Words

anomalous coronary artery
anomalies of coronary artery
coronary arteries anomalies
catheter selection

Abbreviations and Acronyms

ACS
acute coronary syndrome(s)
CT
computed tomographic
FFR
fractional flow reserve
IVUS
intravascular ultrasound
LAD
left anterior descending coronary artery
LCx
left circumflex coronary artery
PCI
percutaneous coronary intervention
RCA
right coronary artery
TAVR
transcatheter aortic valve replacement

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