Multidetector Computed Tomography Evaluation of Congenital Coronary Artery Variants: A Pictorial Essay

The purpose of this pictorial essay is to review the multidetector computed tomography (MDCT) coronary angiography appearance of congenital coronary artery variants [CCAV]. Catheter angiography cannot detect ectopic openings of coronary arteries since it is only a two-dimensional study. Often, a diagnosis of an anomaly is made on MDCT coronary angiography, when catheter angiography fails to show the normal anatomy.

Although CCAVs are relatively uncommon, familiarity with atypical anatomy and their clinical presentation may facilitate appropriate diagnosis and management. Axial sections, multiplanar reconstructions, virtual angioscopy, and 3D volume-rendered images should aid in the detection and improve the interpretation of such anomalies, which can be of immense help to the clinician planning interventional procedures, like stenting, ablation procedures, balloon dilatation, or graft surgery particularly when there are secondary changes of atherosclerosis, calcification, plaque formation and stenosis.