Final Pr. ID: Poster #: CR-004
10-year-old male presented with intermittent fever, cough, shortness of breath, and weight loss. Contrast CT chest performed showed pulmonary thrombus in the right lower lobe branch with necrotizing cavitary pneumonia of the right lower lobe. Dilation of the left coronary artery (LCA) was noted on the chest CT and hence dedicated CT coronary angiography was performed. On CT coronary angiography, there was dilation of the proximal LCA with a wide caliber fistula arising from the LCA, proximal to its bifurcation. The fistula coursed in a retroaortic manner, draining into the right atrium posteriorly at the superior cava-atrial junction. Blood culture showed HACEK organism which is known to be associated with endocarditis. The echocardiogram showed possible vegetation attached to the left side of the atrial septum. After the patient was medically treated with intravenous antibiotics, successful ligation of the fistula was performed at its insertion to the right atrium.
We will discuss in detail as well as illustrate the CT coronary angiography findings in this patient using MIP and 3D reconstructions. We will also describe the types of coronary cameral fistula in detail Read More
Keywords: coronary cameral fistula
Final Pr. ID: Poster #: SCI-008
Diseases of the coronary arteries are rare in children, but can present as unexpected catastrophic events without preceding symptoms. It is essential to identify patients at risk to prevent potentially serious cardiovascular events. Coronary CT angiography (CCTA) has been widely studied in adults, but its clinical applications are not well established in children. Read More
Final Pr. ID: Poster #: SCI-002
To compare the visualization and anatomy of coronary arteries in children (<2 years) with congenital heart disease (CHD) on non-ECG gated and ECG gated computed tomography angiography (CTA). Read More
Final Pr. ID: Paper #: 047
Anomalous Aortic Origin of Coronary Artery (AAOCA) is the 2nd most common cause of sudden cardiac death in the young. Coronary artery origins are evaluated as part of transthoracic echocardiography (TTE) and diagnostic precision may be limited by technical limitations, operator dependence, and patient cooperation. MRI and gated Cardiac Computed Tomographic Angiography (CCTA) are often utilized in patients where an anomaly is suspected on TTE. There is limited literature comparing TTE and CCTA in children with suspected AAOCA. The purpose of this study is to determine the distribution of various coronary anomalies comparing TTE and CCTA data, and define the added value advanced imaging brings in clinical decision-making. Read More
Final Pr. ID: Paper #: 043
AAOCA is the second leading cause of sudden cardiac death in the young which typically occurs with exertion. With in-vitro patient-specific modeling the study aims to assess the differences in fractional flow reserve(FFR)with hyperemia(high-flow)in a patient with AAOCA with a confirmed ischemic event and compare it to a patient with normal coronaries Read More
Final Pr. ID: Poster #: CR-003
Transseptal course is defined as the anomalous course of left coronary artery (LCA) after its anomalous origin from the opposite sinus, when the coronary artery takes a sharp turn to dip into the basal interventricular septum behind the right ventricular outflow tract (RVOT) and emerge laterally to the epicardial surface. Transseptal course is generally considered by some as benign entity. However, case reports of severe cardiac symptoms such as myocardial ischemia, arrhythmia, and even sudden cardiac death have been sporadically reported. Surgical management in symptomatic patients can be challenging. One of the latest surgical approach to this anomaly is transection of the RVOT, unroofing the septal course of the LCA, followed repair of the posterior wall of the RVOT by placement of rectangular strip of autologous pericardium.
We present a 17-year-old male who was noted to have an anomalous left coronary artery on screening echocardiography. CT coronary angiography revealed anomalous origin of left anterior descending artery (LAD) from the right sinus of Valsalva with a long intraconal/transseptal course that measured 43mm in length. The left circumflex artery (LCx) also had anomalous origin from the right sinus of Valsalva with retroaortic course and a fistula with pulmonary artery. This patient had 5 ostia at the right sinus of Valsalva with separate origins of two conus arteries. This patient had successful transconal unroofing of the anomalous LAD and ligation of the LCX to pulmonary artery fistula.
We will discuss the preoperative as well as postoperative CT coronary angiography using multiplanar views, 3D hollow reconstructions, as well as virtual endoluminal views. The CT coronary angiography characteristics of transeptal course of anomalous coronary artery will be discussed in detail. Illustrations with 3D reconstructions which helped our cardiothoracic surgeons to plan the transconal unroofing of the anomalous LAD will be discussed. Recognition of transeptal course of the coronary artery and describing its course and relation to the RVOT including the assessment of the overlying conal septal myocardial thickness with the help of multiplanar views and 3D views can help better surgical planning. Read More
Final Pr. ID: Paper #: 044
Morphological features including intramural course, high ostial location, and slit-like ostium are considered risk factors for sudden death in patients with AAOCA. Assessment of coronary blood flow at rest and hyperemia may contribute to understanding the cause of death, and to risk stratification and management. A patient-specific biomechanical 3D printed model incorporating morphological features derived from CTA was developed to quantify coronary blood flow in AAOCA. Read More
Final Pr. ID: Paper #: 013
To evaluate by CCTA the prevalence and morphology of pediatric LAD MBs (coronary segments that contact or tunnel within myocardium), which are common and usually incidental in adults but only sporadically reported in children. Read More