Imaging diagnosis of congenital left main coronary artery atresia / 中国介入影像与治疗学

ABSTRACT

Objective: To explore the feasibility of imaging diagnosis of congenital left main coronary artery atresia (LMCAA). Methods: Data of 6 patients with LMCAA, including 3 males and 3 females, 5 infants and 1 adult were retrospectively analyzed. All 6 patients underwent echocardiography, multidetector CT (MDCT) and cardiovascular angiography. Results: Echocardiography showed small diameter of left coronary artery without clear ostium, could not exclude the abnormal origin of left coronary artery from pulmonary artery in 1 case, small caliber of proximal segment of the left main coronary artery, intramural left coronary artery or ostial stenosis of the left main coronary artery in another case, mitral valve prolapse with severe regurgitation without coronary arterial abnormality in the rest 4 cases. MDCT correctly diagnosed LMCAA in 5 cases, considered ostium atresia or severe stenosis of the left coronary artery in 1 case. All the 6 patients were definitely diagnosed as LMCAA using cardiovascular angiography in all 6 patients. Conclusion: LMCAA is extremely rare. Echocardiography could reveal this disease, while MDCT may be an useful method. Angiocardiography remains the gold standard for preoperative diagnosis of LMCAA.