RT Journal Article
SR Electronic
T1 Stress-Rest Myocardial Perfusion SPECT for Functional Assessment of Coronary Arteries with Anomalous Origin or Course
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 532
OP 536
VO 45
IS 4
A1 De Luca, Leonardo
A1 Bovenzi, Francesco
A1 Rubini, Domenico
A1 Niccoli-Asabella, Artor
A1 Rubini, Giuseppe
A1 de Luca, Italo
YR 2004
UL http://jnm.snmjournals.org/content/45/4/532.abstract
AB Anomalous coronary arteries (ACAs) may be clinically silent and totally benign or associated with catastrophic and fatal presentations. It has been postulated that the proximal course of an ACA is a decisive factor in risk stratification and surgical approach. Particularly, a course between the aorta and pulmonary trunk carries a high risk of major adverse events. We sought to evaluate the anatomic course of documented ACAs by transesophageal echocardiography (TEE) and to study their functional importance using stress–rest 99mTc-sestamibi (99mTc-MIBI) myocardial perfusion SPECT. Methods: From a cohort of patients undergoing coronary angiography in our department between January 1997 and April 2003, we selected 14 with ACAs but without CAD (9 men and 5 women; mean age, 50.7 ± 14.6 y). All patients underwent TEE and stress–rest 99mTc-MIBI myocardial perfusion SPECT. Results: TEE correctly identified the origin of all ACAs and revealed an anomalous course between the great vessels in 5 patients. At exercise myocardial perfusion SPECT, 4 of 14 patients demonstrated a reversible myocardial perfusion defect. All these patients had an anomalous course between the aorta and pulmonary artery. Conclusion: In this study, 4 of 5 (80%) anomalous courses between the aorta and pulmonary artery were associated with the finding of a reversible perfusion defect on stress–rest SPECT. An integrated evaluation of anatomic course and hemodynamic importance could be useful in the management of ACA.