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Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children

Publication ,  Journal Article
Friedman, AH; Fogel, MA; Stephens, P; Hellinger, JC; Nykanen, DG; Tweddell, J; Feltes, TF; Rome, JJ
Published in: Cardiology in the Young
September 1, 2007

The coronary arteries, the vessels through which both substrate and oxygen are provided to the cardiac muscle, normally arise from paired stems, right and left, each arising from a separate and distinct sinus of the aortic valve. The right coronary artery runs through the right atrioventricular groove, terminating in the majority of instances in the inferior interventricular groove. The main stem of the left coronary artery bifurcates into the anterior descending, or interventricular, and the circumflex branches. Origin of the anterior descending and circumflex arteries from separate orifices from the left sinus of Valsalva occurs in about 1% of the population, while it is also frequent to find the infundibular artery arising as a separate branch from the right sinus of Valsalva. Anomalies of the coronary arteries can result from rudimentary persistence of an embryologic coronary arterial structure, failure of normal development or normal atrophy as part of development, or misplacement of connection of a an otherwise normal coronary artery. Anomalies, therefore, can be summarized in terms of abnormal origin or course, abnormal number of coronary arteries, lack of patency of the orifice of coronary artery, or abnormal connections of the arteries. Anomalous origin of the left coronary artery from the pulmonary trunk occurs with an incidence of approximately 1 in 300,000 children. The degree of left ventricular dysfunction produced likely relates to the development of collateral vessels that arise from the right coronary artery, and provide flow into the left system. Anomalous origin of either the right or the left coronary artery from the opposite sinus of Valsalva can be relatively innocuous, but if the anomalous artery takes an interarterial course between the pulmonary trunk and the aorta, this can underlie sudden death, almost invariably during or immediately following strenuous exercise or competitive sporting events. Distal anomalies of the coronary arteries most commonly involve abnormal connections, or fistulas, between the right or left coronary arterial systems and a chamber or vessel. We discuss the current techniques available for imaging these various lesions, along with their functional assessment, concluding with a summary of current strategies for management. © 2007 Cambridge University Press.

Duke Scholars

Published In

Cardiology in the Young

DOI

EISSN

1467-1107

ISSN

1047-9511

Publication Date

September 1, 2007

Volume

17

Issue

SUPPL. 2

Start / End Page

56 / 67

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Friedman, A. H., Fogel, M. A., Stephens, P., Hellinger, J. C., Nykanen, D. G., Tweddell, J., … Rome, J. J. (2007). Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children. Cardiology in the Young, 17(SUPPL. 2), 56–67. https://doi.org/10.1017/S1047951106001351
Friedman, A. H., M. A. Fogel, P. Stephens, J. C. Hellinger, D. G. Nykanen, J. Tweddell, T. F. Feltes, and J. J. Rome. “Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children.” Cardiology in the Young 17, no. SUPPL. 2 (September 1, 2007): 56–67. https://doi.org/10.1017/S1047951106001351.
Friedman AH, Fogel MA, Stephens P, Hellinger JC, Nykanen DG, Tweddell J, et al. Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children. Cardiology in the Young. 2007 Sep 1;17(SUPPL. 2):56–67.
Friedman, A. H., et al. “Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children.” Cardiology in the Young, vol. 17, no. SUPPL. 2, Sept. 2007, pp. 56–67. Scopus, doi:10.1017/S1047951106001351.
Friedman AH, Fogel MA, Stephens P, Hellinger JC, Nykanen DG, Tweddell J, Feltes TF, Rome JJ. Identification, imaging, functional assessment and management of congenital coronary arterial abnormalities in children. Cardiology in the Young. 2007 Sep 1;17(SUPPL. 2):56–67.
Journal cover image

Published In

Cardiology in the Young

DOI

EISSN

1467-1107

ISSN

1047-9511

Publication Date

September 1, 2007

Volume

17

Issue

SUPPL. 2

Start / End Page

56 / 67

Related Subject Headings

  • Cardiovascular System & Hematology
  • 3201 Cardiovascular medicine and haematology
  • 1102 Cardiorespiratory Medicine and Haematology