Single Coronary Artery Anomaly: Classification and Evaluation Using Multidetector Computed Tomography and Magnetic Resonance Angiography

The aim of this study was to use multidetector computed tomography (MDCT) and magnetic resonance (MRA) angiography to illustrate the classification and clinical characteristics of single coronary artery anomaly (SCAA). Retrospective evaluation of 22 adult and pediatric patients with SCAA by way of a medical archiving system was performed between June 2001 and August 2012. Imaging modalities used for coronary artery evaluation included MRA and MDCT angiography. Of the 22 patients, the majority (n = 8; 36 %) showed an interarterial course, the subtype having the worst prognosis. The retroaortic course (n = 3; 14 %) and course anterior to the pulmonary trunk (n = 3; 14 %) were the next most frequent patterns. Additional types (n = 8; 36 %) included the following: L-I, R-III, septal, and combined. Four patients (18 %) showed atherosclerotic involvement. SCAA anomaly was diagnosed as an incidental finding in the majority of patients evaluated initially for cardiovascular diseases (n = 19; 86 %). Two patients (9 %) required surgical interventions solely for their anomaly. Nine patients (41 %) were found to have coexisting congenital heart disease. Although conventional catheter angiography is responsible for the current classification of SCAA, advanced imaging modalities are useful in the evaluation of morphological and clinical characteristics of single coronary arteries.