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Intracavitary Coronary Artery

An Unusual Coronary Anomaly

Hossain, Rydhwana MD*; Chelala, Lydia MD*; Amin, Sagar B. MD*; Bergquist, Peter J. MD; Vairavamurthy, Jenanan MD*; Jeudy, Jean MD*; White, Charles S. MD*

doi: 10.1097/RTI.0000000000000418
Web Exclusive Content: Original Article
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Purpose: A few case reports of intracavitary coronary arteries (ICCA) have been reported and only a single case series on the coronary computed tomography angiography (CCTA) prevalence rate of ICCA of the right coronary artery (RCA). We describe several cases of ICCA that were noted incidentally and also determine the overall prevalence rate of anomalous ICCA.

Materials and Methods: A retrospective analysis of ICCA was performed consisting of consecutive CCTA cases as well as a group of ICCA from teaching files. To establish a prevalence rate, we reviewed 464 consecutive CCTA referred to our center for transcatheter aortic valve replacement. The presence of ICCA and several imaging features were evaluated.

Results: Our cohort comprises a total of 12 patients with ICCA, with 1 patient containing 2 anomalous ICCA. 83.3% of affected patients were adult males, with an average age of 69.8 years. The RCA was the most commonly affected vessel (53.8%). The mean length of the intracavitary segment was 33.4 mm for the RCA and 27 mm for the LAD. No cases involved the left circumflex coronary artery. Six of the cases were identified routinely as part of clinical practice and therefore not included in the prevalence analysis. On review of our transcatheter aortic valve replacement database, there was a 1.3% prevalence rate of ICCA. RCA had a prevalence of 0.4%, whereas LAD had a prevalence of 0.9%.

Conclusions: Although rare, our study suggests that ICCA may be more common than previously described. Its presence is important to communicate to clinicians prior to invasive cardiac procedures to prevent potentially catastrophic outcomes.

*Department of Radiology, University of Maryland School of Medicine, Baltimore, MD

Department of Radiology, MedStar Georgetown University Hospital, Washington, DC

Appropriate institutional review board approved this study.

The authors declare no conflicts of interest.

Correspondence to: Rydhwana Hossain, MD, Department of Radiology, University of Maryland School of Medicine, Baltimore, MD 21201 (e-mail: rydhwana.h@gmail.com).

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