Imaging of congenital coronary anomalies with multislice computed tomography

OBJECTIVE: To describe a single-center experience of using retrospectively gated multislice computed tomographic (MSCT) coronary angiography for imaging congenital coronary anomalies. PATIENTS AND METHODS: We retrospectively reviewed the clinical information and imaging studies for 9 patients diagnosed as having congenital coronary anomalies on invasive, selective coronary angiography between February 2001 and October 2003 at the Mayo Clinic in Jacksonville, Fla. Two experienced observers classified by consensus the origin and proximal course of the abnormal coronary arteries as seen on MSCT. RESULTS: In 1 patient, MSCT showed a normal but extremely anterior origin of the right coronary artery from the right aortic sinus of Valsalva. In the other 8 patients, the origin and course of 4 anomalous right coronary arteries, 2 anomalous left circumflex coronary arteries, and 2 single coronary arteries were recognized easily on MSCT. CONCLUSION: Similar to electron beam computed tomography and magnetic resonance imaging, widely available MSCT can characterize the proximal course of congenially abnormal coronary arteries and thus aid in clinical decision making for patients with such anomalies.