Coronariaeredési anomáliák kardio-CT-vizsgálatok során

Osszefoglalo. Bevezetes: Congenitalis coronariaanomalianak tekintik azokat a coronariamorfologiai rendellenessegeket, melyek 1%-nal kisebb gyakorisaggal fordulnak elő. Tobbseguk nem jar tunettel, olykor azonban okozhatnak mellkasi fajdalmat, eszmeletvesztest, es hirtelen halalhoz is vezethetnek. A coronariaanomaliak gyakorisagarol Magyarorszagon eddig csak invaziv koronarografias adatok alapjan jelent meg kozlemeny. Celkitűzes: Jelen vizsgalatunkban a coronariak eredesi rendellenessegeinek gyakorisagat mertuk fel intezetunk coronaria-komputertomografias angiografian atesett betegeinel. Modszer: A coronaria-komputertomografias vizsgalatra kerult betegek felveteleinek ertekelesekor rogzitettuk a coronariaanomalia jelenletet. A vizsgalat indikacioja altalaban mellkasi fajdalom volt. 128 szeletes berendezest hasznaltunk, a vizsgalatok soran reszben retrospektiv, reszben prospektiv EKG-kapuzast alkalmaztunk. Eredmenyek: 1751 beteg komputertomografias angiografias felveteleit elemeztuk. A betegek kozott a ferfiak aranya 38,4%, a vizsgalatra kerulők eletkoranak atlaga pedig 58,07 ± 11,07 ev volt. Eredesi anomaliat 1,83%-ban talaltunk, ezen belul a leggyakoribb volt a korbefuto ag (ramus circumflexus) es az elulső leszallo ag kulonallo eredese a bal Valsalva-sinusbol (1%). A tovabbi rendellenessegek a kovetkezők voltak: a jobb coronaria eredese magasan az aortabol (0,34%), ramus circumflexus a jobb sinusbol vagy a jobb coronariabol (0,34%), jobb coronaria a bal Valsalva-sinusbol (0,057%), elulső leszallo ag reszben a bal Valsalva-sinusbol a circumflexustol kulon, reszben a jobb coronariabol (kettős elulső leszallo ag, 0,057%). Kovetkeztetes: Mindossze 0,057%-ban fordult elő potencialisan tunetet okozo coronariaeredesi rendellenesseg (a bal sinusbol eredő jobb coronaria). A komputertomografias angiografia segitsegevel a coronariaeredes helye pontosan megallapithato, tisztazhato az er lefutasa es ennek soran viszonya a kornyező strukturakhoz. Orv Hetil. 2020; 161(47): 1995-1999. Introduction Congenital coronary artery anomaly is defined as a coronary morphology which occurs in less than 1% of the cases. Usually these anomalies do not result in symptoms but sometimes they can cause chest pain, syncope and sudden death. In Hungary, the prevalence of these abnormalities was published only from data of invasive coronary angiography. Objective In this study, we evaluated the prevalence of the anomalies of coronary origin in the patients of our institution undergoing coronary computed tomography. Method While reading the computed tomography angiograms of our patients, we registered the presence of coronary anomalies. In most of the cases, the indication of the coronary computed tomography was chest pain. A scanner with 128 detectors was used, scans were performed partly with prospective, partly with retrospective ECG gating. Results We assessed 1751 patients. The ratio of males was 38.4%, while the average age of patients 58.07 ± 11.07 years. Anomaly of coronary origin was present in 1.83% of our patients, with the separate origin of left anterior descending and left circumflex artery being the most frequent (1%) among them. Other anomalies were as follows: high take-off of the right coronary artery from the ascending aorta (0.34%), left circumflex arising from the right sinus of Valsalva or from the right coronary (0.34%), right coronary artery from the left sinus of Valsalva (0.057%), left anterior descending arising partly from the left sinus of Valsalva, apart from the left circumflex, partly from the right coronary (dual left anterior descending artery, 0.057%). Conclusion The prevalence of potentially symptomatic coronary anomalies was only 0.057% in our series (right coronary from the left sinus of Valsalva). The computed tomography angiography can precisely define the origin of the coronary artery, depict its run-off and its relationship to the neighbouring structures. Orv Hetil. 2020; 161(47): 1995-1999.