Coronary artery anomalies | Revista Portuguesa de Cardiologia (English edition)

array:24 ["pii" => "S2174204912000955" "issn" => "21742049" "doi" => "10.1016/j.repce.2011.12.018" "estado" => "S300" "fechaPublicacion" => "2012-07-01" "aid" => "113" "copyright" => "Sociedade Portuguesa de Cardiologia" "copyrightAnyo" => "2010" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2012;31:477-84" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 6852 "formatos" => array:3 [ "EPUB" => 134 "HTML" => 5917 "PDF" => 801 ] ] "itemSiguiente" => array:19 [ "pii" => "S2174204912001201" "issn" => "21742049" "doi" => "10.1016/j.repce.2012.01.017" "estado" => "S300" "fechaPublicacion" => "2012-07-01" "aid" => "114" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "sco" "cita" => "Rev Port Cardiol. 2012;31:485-92" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 4353 "formatos" => array:3 [ "EPUB" => 160 "HTML" => 3498 "PDF" => 695 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Case report" "titulo" => "Are intraventricular gradients a cause of false positive treadmill exercise tests?" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "485" "paginaFinal" => "492" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Serão os gradientes intraventriculares uma causa de falsos positivos de prova de esforço?" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1211 "Ancho" => 1646 "Tamanyo" => 132738 ] ] "descripcion" => array:1 [ "en" => "Patient 8: echocardiographic findings in Table 2. Intraventricular gradient of 100.54mmHg with a biphasic wave and late systolic peak detected during DSE at a heart rate of 161bpm." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Nuno Cardim, Pedro Campos, Daniel Ferreira, Vanda Carmelo, Júlia Toste, Marisa Trabulo, Teresa Santos, Sylvie da Mariana, Francisco Pereira Machado, José Roquette" "autores" => array:10 [ 0 => array:2 [ "nombre" => "Nuno" "apellidos" => "Cardim" ] 1 => array:2 [ "nombre" => "Pedro" "apellidos" => "Campos" ] 2 => array:2 [ "nombre" => "Daniel" "apellidos" => "Ferreira" ] 3 => array:2 [ "nombre" => "Vanda" "apellidos" => "Carmelo" ] 4 => array:2 [ "nombre" => "Júlia" "apellidos" => "Toste" ] 5 => array:2 [ "nombre" => "Marisa" "apellidos" => "Trabulo" ] 6 => array:2 [ "nombre" => "Teresa" "apellidos" => "Santos" ] 7 => array:2 [ "nombre" => "Sylvie" "apellidos" => "da Mariana" ] 8 => array:2 [ "nombre" => "Francisco" "apellidos" => "Pereira Machado" ] 9 => array:2 [ "nombre" => "José" "apellidos" => "Roquette" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912001201?idApp=UINPBA00004E" "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912001201/v1_201308021407/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2174204912000980" "issn" => "21742049" "doi" => "10.1016/j.repce.2011.12.020" "estado" => "S300" "fechaPublicacion" => "2012-07-01" "aid" => "116" "copyright" => "Sociedade Portuguesa de Cardiologia" "documento" => "article" "crossmark" => 0 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "fla" "cita" => "Rev Port Cardiol. 2012;31:469-76" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 5623 "formatos" => array:3 [ "EPUB" => 158 "HTML" => 4681 "PDF" => 784 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Tilt training increases vasoconstrictor reserve in patients with neurocardiogenic syncope" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "pt" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "469" "paginaFinal" => "476" ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "O treino de ortostatismo (tilt training) aumenta a reserva vasoconstritora em doentes com síncope reflexa neurocardiogénica" ] ] "contieneResumen" => array:2 [ "en" => true "pt" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 2785 "Ancho" => 2493 "Tamanyo" => 293102 ] ] "descripcion" => array:1 [ "en" => "Changes in hemodynamic variables between the first and the ninth tilt training sessions. Note changes in response leading to improved adaptation." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Sérgio Laranjo, Mário Martins Oliveira, Cristiano Tavares, Vera Geraldes, Sofia Santos, Eunice Oliveira, Rui Ferreira, Isabel Rocha" "autores" => array:8 [ 0 => array:2 [ "nombre" => "Sérgio" "apellidos" => "Laranjo" ] 1 => array:2 [ "nombre" => "Mário Martins" "apellidos" => "Oliveira" ] 2 => array:2 [ "nombre" => "Cristiano" "apellidos" => "Tavares" ] 3 => array:2 [ "nombre" => "Vera" "apellidos" => "Geraldes" ] 4 => array:2 [ "nombre" => "Sofia" "apellidos" => "Santos" ] 5 => array:2 [ "nombre" => "Eunice" "apellidos" => "Oliveira" ] 6 => array:2 [ "nombre" => "Rui" "apellidos" => "Ferreira" ] 7 => array:2 [ "nombre" => "Isabel" "apellidos" => "Rocha" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912000980?idApp=UINPBA00004E" "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912000980/v1_201308021407/en/main.assets" ] "en" => array:21 [ "idiomaDefecto" => true "cabecera" => "Original article" "titulo" => "Coronary artery anomalies" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "477" "paginaFinal" => "484" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Carla Almeida, Raquel Dourado, Carina Machado, Emília Santos, Nuno Pelicano, Miguel Pacheco, Anabela Tavares, Fernando Melo, Manuela Matos, José Vieira Faria, Dinis Martins" "autores" => array:11 [ 0 => array:4 [ "nombre" => "Carla" "apellidos" => "Almeida" "email" => array:1 [ 0 => "correio.carla@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "¿" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "Raquel" "apellidos" => "Dourado" ] 2 => array:2 [ "nombre" => "Carina" "apellidos" => "Machado" ] 3 => array:2 [ "nombre" => "Emília" "apellidos" => "Santos" ] 4 => array:2 [ "nombre" => "Nuno" "apellidos" => "Pelicano" ] 5 => array:2 [ "nombre" => "Miguel" "apellidos" => "Pacheco" ] 6 => array:2 [ "nombre" => "Anabela" "apellidos" => "Tavares" ] 7 => array:2 [ "nombre" => "Fernando" "apellidos" => "Melo" ] 8 => array:2 [ "nombre" => "Manuela" "apellidos" => "Matos" ] 9 => array:2 [ "nombre" => "José" "apellidos" => "Vieira Faria" ] 10 => array:2 [ "nombre" => "Dinis" "apellidos" => "Martins" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Serviço de Cardiologia, Hospital Divino Espírito Santo, EPE de Ponta Delgada, Ponta Delgada, Açores, Portugal" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Anomalias das artérias coronárias" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1455 "Ancho" => 1333 "Tamanyo" => 274157 ] ] "descripcion" => array:1 [ "en" => "Absence of LMVA, anterior descending and circumflex with separate ostia in 3D volume-rendered reconstruction (A)." ] ] ] "textoCompleto" => "IntroductionCoronary artery anomalies (CAAs) are congenital alterations in the origin, course or structure of the epicardial coronary arteries.The true incidence of CAAs in the general population has yet to be determined, published series reporting very different percentages. Alexander and Griffith<a class="elsevierStyleCrossRef" href="#bib0005">1</a> found an incidence of 0.3% in 1956, based on autopsy studies. In 1993, Cieslinski et al.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> reported an incidence of 0.97% in 4016 patients undergoing angiography between 1985 and 1989. However, these figures do not reflect the true incidence of CAAs in the general population, since autopsy studies are not performed as a matter of routine but for legal purposes, and angiography was performed in a selected group of patients in the latter study.In 2002, Angelini<a class="elsevierStyleCrossRef" href="#bib0015">3</a> found an incidence of around 1% in the general population, while a previous prospective analysis by the same author of 1950 patients undergoing cardiac computed tomography (CT) angiography reported an incidence of 5.64%,<a class="elsevierStyleCrossRef" href="#bib0020">4</a> much higher than in previous studies.By definition, CAAs occur in less than 1% of the general population,<a class="elsevierStyleCrossRef" href="#bib0025">5</a> alterations with a higher incidence being considered variants of normal. No evidence has been found of differences in incidence according to gender or ethnicity.Despite this uncertainty as to the true incidence of CAAs in the general population, there is evidence of higher incidence among young athletes and members of the armed forces who have suffered sudden cardiac death. In a registry of sudden death in athletes aged under 35 years, in whom cardiovascular disease was the demonstrated cause of death on autopsy, anomalous origin of a coronary artery in the opposite coronary sinus was responsible in 13% of cases, second only to hypertrophic cardiomyopathy.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> This illustrates the impact that strenuous physical activity can have on prognosis in these patients, and makes the true incidence of CAAs an issue of public health rather than of mere academic interest.The authors review the literature and present a study on the incidence of CAAs in a population of patients undergoing cardiac CT angiography.ClassificationThere is no consensus on the classification of CAAs. The principle behind the system proposed by Angelini<a class="elsevierStyleCrossRef" href="#bib0035">7</a> (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) is that the denomination of an artery is determined by the territory it supplies rather than by its origin or initial course. Thus, the right coronary artery (RCA) is the vessel that provides blood flow to the right ventricular (RV) free wall, the left anterior descending artery (LAD) provides blood flow to the anterior interventricular septum, and the circumflex artery (Cx) provides blood flow to the left ventricular (LV) free wall, on the obtuse margin of the heart.<elsevierMultimedia ident="tbl0005"></elsevierMultimedia>According to the same author, the following are considered normal features of the coronary anatomy: 2–4 ostia, located in the right and left coronary sinuses, with proximal orientation 45–90° to the wall of the aorta; the presence of a single common stem or trunk, the left main coronary artery (LMCA) (giving rise to the LAD and Cx); a direct proximal course, from ostium to destination; a subepicardial mid course, with adequate branches for the dependent myocardium, and terminating in capillaries.Other authors have proposed classifying CAAs as severe, malignant or major versus minor, depending on their hemodynamic and clinical significance.<a class="elsevierStyleCrossRef" href="#bib0040">8</a>Regarding the incidence of the different anomalies, in the prospective analysis of 1950 patients undergoing CT angiography, Angelini<a class="elsevierStyleCrossRef" href="#bib0020">4</a> found the incidences shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>.<elsevierMultimedia ident="tbl0010"></elsevierMultimedia>Pathophysiology and clinical presentationWhile most CAAs are asymptomatic, clinical presentation in adults as a result of myocardial ischemia can be in the form of angina, arrhythmias, syncope, infarction or sudden death. The latter is generally triggered by strenuous physical activity<a class="elsevierStyleCrossRef" href="#bib0045">9</a> (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<elsevierMultimedia ident="tbl0015"></elsevierMultimedia>Of the various CAAs, origin of the LMCA in the right coronary sinus or of the RCA in the left sinus is associated with greater risk of sudden death.<a class="elsevierStyleCrossRefs" href="#bib0050">10,11</a> This is because such anomalies can lead to an acute angle in the artery's initial course or an interarterial course between the aorta and the pulmonary artery (PA), which dilate during exercise and compress the coronary artery.CAAs can occur in isolation or be associated with other congenital disease, including transposition of the great vessels, tetralogy of Fallot and some forms of pulmonary atresia.<a class="elsevierStyleCrossRefs" href="#bib0060">12,13</a> In such cases, symptoms usually appear earlier and the diagnosis is made before adulthood.To date no genetic mutations have been linked to CAAs. However, an article<a class="elsevierStyleCrossRef" href="#bib0070">14</a> published in 2008 identified five cases of CAAs during screening of patients’ relatives; the authors highlight the need for further research in this area, given the malignant nature of some of these anomalies.Diagnosis and screeningDiagnosing CAAs is a challenge, since patients are usually asymptomatic and physical examination reveals no abnormalities.Given the fatal prognosis of certain CAAs, there is a need to develop screening methods, ideally noninvasive, as well as to define the target population.As CAAs are the second leading cause of sudden death in young athletes, there is general agreement that a screening protocol should be established for young competitive athletes and those engaged in strenuous physical activity. The most appropriate diagnostic exams have yet to be defined.Electrocardiogram/exercise testing/Holter monitoringThere are no specific electrocardiographic alterations that indicate a diagnosis of CAA. The presence of abnormalities suggestive of ischemia or cardiac arrhythmia in children or young adults can raise suspicion and prompt other diagnostic exams.EchocardiographyEchocardiography is an attractive screening method since it is noninvasive, widely available, inexpensive and does not involve ionizing radiation. However, studies have reported variable sensitivity in diagnosing CAAs; the exam is dependent on the expertise of the operator, the age of the patient and the anomaly involved, transthoracic echocardiography gives better results in children than in adults, and the left coronary artery (LCA) is easier to identify than the RCA.<a class="elsevierStyleCrossRef" href="#bib0075">15</a>Transesophageal echocardiography has greater sensitivity in detecting CAAs and can define their proximal course and flow pattern, but it is nevertheless a semi-invasive procedure.<a class="elsevierStyleCrossRef" href="#bib0080">16</a>Invasive coronary angiographyConventional coronary angiography has been considered the gold standard method for diagnosing CAAs. However, it is an invasive exam and requires the use of nephrotoxic contrast agents and ionizing radiation. Furthermore, new imaging techniques, particularly cardiac CT angiography and magnetic resonance imaging (MRI), that provide three-dimensional assessment of the origin and course of arteries and their relationship to adjacent structures, have revealed certain shortcomings of invasive coronary angiography for the diagnosis of CAAs.<a class="elsevierStyleCrossRef" href="#bib0085">17</a>Noninvasive coronary assessment by CT angiography and MRINoninvasive coronary assessment by CT angiography has evolved considerably in recent years. It is now a widely used method of assessing the coronary arteries, both for detecting atherosclerotic disease and identifying anomalies of origin or course, and several studies have demonstrated its accuracy for the latter purpose.<a class="elsevierStyleCrossRefs" href="#bib0090">18–20</a>Cardiac CT angiography provides better characterization of the origin of coronary arteries when selective characterization of the vessels is difficult, or even impossible, by invasive coronary angiography.<a class="elsevierStyleCrossRef" href="#bib0105">21</a>The American Heart Association considers cardiac CT angiography an appropriate technique for diagnosis of CAAs, awarding it a score of 9, the maximum for a diagnostic method for a particular purpose.<a class="elsevierStyleCrossRef" href="#bib0110">22</a>Recent advances in cardiac CT angiography have enabled more and better information to be obtained, while requiring ever smaller radiation doses, which overcomes an important disadvantage of its use compared to cardiac MRI.Magnetic resonance coronary angiography is a noninvasive method that has advantages over cardiac CT angiography and conventional coronary angiography, namely that it does not require the use of nephrotoxic contrast agents or ionizing radiation.<a class="elsevierStyleCrossRef" href="#bib0115">23</a> Its disadvantages are lengthy acquisition time and the fact that it is not widely available.Both CT angiography and cardiac MRI require a degree of collaboration on the part of the patient, notably the ability to perform a breath-hold.In the ACC/AHA 2008 guidelines for the management of adults with congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0120">24</a> cardiac CT angiography and cardiac MRI have a class I recommendation, level of evidence B, for the diagnosis of CAAs.Given that CT angiography is more widely available than cardiac MRI and that it provides better definition than conventional angiography of the origin and course of coronary arteries and their relationship to other anatomical structures, it appears to be the method of choice in most cases of suspected CAA.The initial approach in symptomatic patients should be a 12-lead electrocardiogram, exercise test and echocardiogram, which can suggest the diagnosis in some cases or reveal another cause of symptoms. Cardiac CT angiography should then be performed. Cardiac MRI, which has less potentially harmful effects, may have a role in screening asymptomatic individuals, particularly athletes.TreatmentThe European Society of Cardiology guidelines for the management of grown-up congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0125">25</a> do not cover the treatment of patients with CAAs. In the ACC/AHA 2008 guidelines for the management of adults with congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0120">24</a> (<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>), surgical revascularization is indicated in cases of the LMCA originating in the right coronary sinus and coursing between the aorta and PA (class I recommendation, level of evidence B) and of anomalies with an interarterial course with evidence of ischemia (class I recommendation, level of evidence B).<elsevierMultimedia ident="tbl0020"></elsevierMultimedia>ObjectiveTo assess the incidence of CAA in a population of patients undergoing cardiac CT angiography.MethodsWe performed a retrospective study of 360 patients who underwent cardiac CT angiography in our institution between October 2009 and April 2011.The exams were performed on a 64-slice scanner (Somatom Definition®, Siemens Medical Solutions).Patients with heart rate of over 65bpm were medicated with 100mg oral metoprolol one hour before the exam, and all received sublingual nitroglycerin prior to image acquisition.Demographic, clinical and angiographic characteristics were studied. CAAs were classified according to a modified version of the classification proposed by Angelini<a class="elsevierStyleCrossRef" href="#bib0035">7</a> (intramyocardial courses not being considered anomalous). Significant coronary artery disease was defined as the presence of atherosclerotic plaques causing >50% stenosis.ResultsOf the 360 patients undergoing cardiac CT angiography, 26 were excluded as images were not acquired, of whom 23 presented a calcium score of >1000 (indicating a high probability of the images being uninterpretable or of significant coronary artery disease) and three were unable to perform the breathhold.Of the 334 patients assessed, 41% were male and mean age was 59±14 years.Of this group, nine presented CAAs, an incidence of 2.69%. Four patients were male, and mean age was 61±11 years.All patients were symptomatic (chest pain). The indications for cardiac CT angiography were inability to perform an exercise test in five patients, inconclusive ischemia test in two (one after myocardial perfusion scintigraphy and one after stress echocardiography), assessment of stent patency in one, and inability to selectively catheterize the coronary artery by conventional angiography in the other patient.The most prevalent risk factors were hypertension (77.8%, seven patients) and dyslipidemia (55.6%, five patients).The CAAs diagnosed (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>) were: anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>); two cases of anomalous origin of the RCA in the left coronary sinus coursing between the aorta and PA (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>); anomalous origin of the LCA in the non-coronary sinus (<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>); single RCA (<a class="elsevierStyleCrossRef" href="#fig0025">Figure 5</a>); anomalous origin of the RCA in the left coronary sinus (benign variant); anomalous origin of the Cx from the RCA coursing between the aorta and the left atrium (<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>); and two cases of separate ostia (<a class="elsevierStyleCrossRef" href="#fig0030">Figure 6</a>).<elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia>Four of these patients had non-significant CAD, and one had significant coronary disease.All patients are currently under medical therapy; one (patient 1 – <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>) is awaiting ischemia testing to guide therapeutic decision-making (surgical revascularization or angioplasty).DiscussionWhen classifying CAAs, our group opted not to include intramyocardial courses, as various studies have reported that these occur in more than 1% of the population, and are thus a variant of normal. However, this definition is prior to 2002, and in the latest classification proposed by Angelini they are considered anomalies.The incidence of CAAs in our selected patient group was 2.69%, higher than reported in the general population, although it should be borne in mind that incidence in the general population was also based on selected patient groups, namely those undergoing autopsy or invasive coronary angiography.Two other Portuguese retrospective studies have been published to date, of 3906<a class="elsevierStyleCrossRef" href="#bib0130">26</a> and 3660<a class="elsevierStyleCrossRef" href="#bib0135">27</a> patients undergoing coronary angiography, which found CAA prevalences of 0.54% and 0.68%, respectively.With regard to treatment, only patients 1, 2 and 3 (<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>) had CAAs with surgical indication according to the guidelines. In the first case, besides anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA, a lesion causing 90% stenosis was also detected in the distal Cx. With a view to deciding the most appropriate treatment in this patient (surgical revascularization or angioplasty), stress echocardiography was performed to assess whether the ischemia causing the symptoms was in the territory of the LAD or of the Cx. However, the exam was inconclusive, and the patient is awaiting myocardial perfusion scintigraphy.In the second case, the RCA had a subpulmonary course and so the patient was not considered for surgery; in addition, the patient's symptoms could also have been related to his hypertrophic cardiomyopathy.The identification of CAAs associated with sudden death – anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA, and single RCA – in older adults (aged 77 and 76 years, respectively) makes these cases unusual; the fact that these patients had not previously presented any ischemic complications casts doubt on the malignancy of their anomalies, especially in the first case, which was not treated surgically.Our series included two cases of separate ostia (absence of the LMCA). While normally not considered a CAA, it is included in the classification proposed by Angelini. If included, the incidence in our population was 2.69%, if excluded the incidence falls to 2.10%.There is currently no national registry of cardiac CT angiography in Portugal. Such a registry could contribute to a better understanding of this and other heart diseases.ConclusionsCAAs are rare and can be asymptomatic, but they are nevertheless the second leading cause of death in apparently healthy young athletes.There is ongoing debate concerning their incidence, classification, screening, heritability and treatment.The authors suggest the establishment of a national registry of cardiac CT angiography, which would contribute to a better understanding of this and other cardiac diseases and enrich current knowledge about noninvasive cardiac imaging in Portugal.Conflicts of interestThe authors have no conflicts of interest to declare." "textoCompletoSecciones" => array:1 [ "secciones" => array:17 [ 0 => array:2 [ "identificador" => "xres251789" "titulo" => "Abstract" ] 1 => array:2 [ "identificador" => "xpalclavsec239387" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres251788" "titulo" => "Resumo" ] 3 => array:2 [ "identificador" => "xpalclavsec239386" "titulo" => "Palavras-chave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Classification" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Pathophysiology and clinical presentation" ] 7 => array:3 [ "identificador" => "sec0020" "titulo" => "Diagnosis and screening" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "sec0025" "titulo" => "Electrocardiogram/exercise testing/Holter monitoring" ] 1 => array:2 [ "identificador" => "sec0030" "titulo" => "Echocardiography" ] 2 => array:2 [ "identificador" => "sec0035" "titulo" => "Invasive coronary angiography" ] 3 => array:2 [ "identificador" => "sec0040" "titulo" => "Noninvasive coronary assessment by CT angiography and MRI" ] ] ] 8 => array:2 [ "identificador" => "sec0045" "titulo" => "Treatment" ] 9 => array:2 [ "identificador" => "sec0050" "titulo" => "Objective" ] 10 => array:2 [ "identificador" => "sec0055" "titulo" => "Methods" ] 11 => array:2 [ "identificador" => "sec0060" "titulo" => "Results" ] 12 => array:2 [ "identificador" => "sec0065" "titulo" => "Discussion" ] 13 => array:2 [ "identificador" => "sec0070" "titulo" => "Conclusions" ] 14 => array:2 [ "identificador" => "sec0075" "titulo" => "Conflicts of interest" ] 15 => array:2 [ "identificador" => "xack54272" "titulo" => "Acknowledgements" ] 16 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2010-07-22" "fechaAceptado" => "2012-01-25" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec239387" "palabras" => array:3 [ 0 => "Coronary artery anomalies" 1 => "64-Slice CT" 2 => "Cardiac CT National Registry" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec239386" "palabras" => array:3 [ 0 => "Anomalias das artérias coronárias" 1 => "Angio TC de 64 cortes" 2 => "Registo Nacional das AngioTC Cardíacas" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "Coronary artery anomalies (CAAs) are a rare entity but their true incidence in the general population has yet to be determined. Most CAAs are asymptomatic, but they are nevertheless the second leading cause of sudden death in apparently healthy young athletes.The new imaging methods available to cardiologists, including CT angiography and MRI, now enable noninvasive diagnosis and characterization of these anomalies.The authors review the literature and present a retrospective study of 360 consecutive patients who underwent cardiac CT angiography. Demographic, clinical and angiographic characteristics were studied. The incidence of CAAs in this population was 2.69%.In order to better characterize this disorder, including diagnostic strategy, screening, treatment and prognosis, the authors suggest the establishment of a national registry of cardiac CT angiography. Such a registry would fill the existing gap in information on exams performed in the country, enriching current knowledge about this disease and noninvasive cardiac imaging in Portugal." ] "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "As anomalias das artérias coronárias (AAC) são uma entidade rara mas a sua verdadeira incidência na população em geral continua por definir. A maioria das AAC são assintomáticas, no entanto, constituem a segunda causa de morte súbita em jovens atletas, aparentemente saudáveis.Os novos métodos de imagem ao dispor da Cardiologia, nomeadamente a AngioTC e a RM, permitem o diagnóstico e a caracterização não invasiva desta patologia.Os autores fazem uma revisão da literatura e apresentam um estudo retrospectivo de 360 doentes consecutivos, submetidos a AngioTC cardíaca. Foram estudadas variáveis demográficas, clínicas e angiográficas. Nesta população a incidência de AAC foi de 2,69%.Para melhor caracterização desta patologia, nomeadamente estratégia diagnóstica, de rastreio, terapêutica e prognóstico, os autores sugerem a realização de um Registo Nacional das AngioTC cardíacas. Este registo vai colmatar uma lacuna existente ao nível da informação dos exames realizados, enriquecendo o conhecimento actual sobre a patologia e a imagiologia cardíaca não invasiva em Portugal." ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Almeida, C; Anomalias das Artérias Coronárias. Rev Port Cardiol 2012;31(7-8):477-484." ] ] "multimedia" => array:11 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1007 "Ancho" => 1667 "Tamanyo" => 237689 ] ] "descripcion" => array:1 [ "en" => "Anomalous origin of the LCA (1) in the right coronary sinus coursing between the aorta (3) and PA (4) in 3D volume-rendered reconstruction (A) and in axial view (B)." ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1015 "Ancho" => 2500 "Tamanyo" => 338457 ] ] "descripcion" => array:1 [ "en" => "Anomalous origin of the RCA (1) in the left coronary sinus coursing between the aorta (3) and PA (4) in 3D volume-rendered reconstruction (A and B) and in axial view (C)." ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 1232 "Ancho" => 1667 "Tamanyo" => 259109 ] ] "descripcion" => array:1 [ "en" => "Anomalous origin of the LCA (1) in the non-coronary sinus, in 3D volume-rendered reconstruction (A) and in axial view (B)." ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 872 "Ancho" => 1667 "Tamanyo" => 174640 ] ] "descripcion" => array:1 [ "en" => "Anomalous origin of the Cx (1) in the proximal RCA (2) coursing between the aorta (3) and left atrium (5) in 3D volume-rendered reconstruction (A and B)." ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1023 "Ancho" => 1667 "Tamanyo" => 270671 ] ] "descripcion" => array:1 [ "en" => "Single RCA (1) in 3D volume-rendered reconstruction (A and B)." ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1455 "Ancho" => 1333 "Tamanyo" => 274157 ] ] "descripcion" => array:1 [ "en" => "Absence of LMVA, anterior descending and circumflex with separate ostia in 3D volume-rendered reconstruction (A)." ] ] 6 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Adapted from Angelini et al.<a class="elsevierStyleCrossRef" href="#bib0035">7</a>" "tabla" => array:2 [ "leyenda" => "Cx: circumflex artery; LAD: left anterior descending artery; LMCA: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">A. Anomalies of origin and course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Absent LMCA (split origin of LCA) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. Anomalous location of coronary ostium within aortic root or near proper aortic sinus of Valsalva for each artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. High \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. Low \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Commissural \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. Anomalous location of coronary ostium outside normal coronary aortic sinuses \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. Right posterior aortic sinus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. Ascending aorta \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Left ventricle \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">d. Right ventricle \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">e. Pulmonary artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">f. Aortic arch \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">g. Innominate artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">h. Right carotid artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">i. Internal mammary artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">j. Bronchial artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">k. Subclavian artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">l. Descending thoracic aorta \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. Anomalous location of coronary ostium in improper sinus – variants \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. RCA arises from left coronary sinus, with anomalous course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">i. Posterior atrioventricular groove or retrocardiac \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ii. Retroaortic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iii. Between aorta and PA (intramural) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iv. Intraseptal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">v. Anterior to pulmonary outflow tract or precardiac \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">vi. Posteroanterior interventricular groove \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. LAD arises from right anterior sinus, with anomalous course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">i. Between aorta and PA (intramural) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ii. Intraseptal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iii. Anterior to pulmonary outflow tract or precardiac \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iv. Posteroanterior interventricular groove \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Cx arises from right coronary sinus, with anomalous course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">i. Posterior atrioventricular groove \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ii. Retroaortic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">d. LMCA arises from right anterior sinus, with anomalous course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">i. Posterior atrioventricular groove or retrocardiac \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">ii. Retroaortic \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iii. Between aorta and PA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">iv. Intraseptal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">v. Anterior to pulmonary outflow tract or precardiac \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">vi. Posteroanterior interventricular groove from Angelini et al. 1999.<a class="elsevierStyleCrossRef" href="#bib0020">4</a> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. Single coronary artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B. Anomalies of intrinsic coronary arterial anatomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Congenital ostial stenosis or atresia (LMCA, LAD, RCA, Cx) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. Coronary ostial dimple \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. Coronary aneurysm or ectasia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4. Absent coronary artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5. Coronary hypoplasia \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6. Intramural coronary artery (muscular bridge) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7. Subendocardial coronary course \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8. Coronary crossing \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9. Anomalous origin of posterior descending artery from the anterior descending branch or a septal penetrating branch \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10. Split RCA – variants \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. Proximal and distal posterior descending branches that both arise from the RCA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. Proximal posterior descending branch that arises from the RCA, distal posterior descending branch that arises from the LAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Parallel posterior descending branches×2 (arising from RCA, Cx) or “codominant” \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11. Split LAD – variants \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. LAD+first large septal branch \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. LAD, double (parallel LADs) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">12. Ectopic origin of first septal branch \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. RCA \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. Right sinus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Diagonal \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">d. Ramus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">e. Cx \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C. Anomalies of coronary termination \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Inadequate arteriolar/capillary ramifications \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. Fistulas from RCA, LMCA or infundibular artery \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">D. Anomalous anastomotic vessels \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355057.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Classification of coronary artery anomalies." ] ] 7 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Adapted from Angelini et al.<a class="elsevierStyleCrossRef" href="#bib0020">4</a>" "tabla" => array:2 [ "leyenda" => "CAAs: coronary artery anomalies; Cx: circumflex artery; LCA: left coronary artery; RCA: right coronary artery." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">n \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">% \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CAAs \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">110 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.64 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Split RCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">24 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ectopic RCA (right cusp) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.13 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ectopic RCA (left cusp) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">18 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.92 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fistulas \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">17 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.87 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Absent LCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.67 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Cx arising from right cusp \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">13 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.67 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LCA arising from right cusp \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.15 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Low origin of RCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Other anomalies \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.27 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355055.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Incidence of CAAs in a series of 1950 CT angiograms." ] ] 8 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "fuente" => "Adapted from Angelini et al.<a class="elsevierStyleCrossRef" href="#bib0045">9</a>" "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Group (age) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">No. of deaths \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Deaths related to coronary anomalies (%) \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exercising individuals (8–66 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">550 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">11 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">General population (<40 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">162 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Competitive athletes (mean age: 17 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">134 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">23 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Runners (30–46 years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">120 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Exercising individuals, Maryland, USA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">62 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355054.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Incidence of sudden death related to coronary artery anomalies." ] ] 9 => array:7 [ "identificador" => "tbl0020" "etiqueta" => "Table 4" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Ao: aorta; LAD: left anterior descending artery; LMCA: left main coronary artery; PA: pulmonary artery; RCA: right coronary artery." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Recommendation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Level of evidence \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Class I</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. The evaluation of individuals who have survived unexplained aborted sudden cardiac death or with unexplained life-threatening arrhythmia, coronary ischemic symptoms, or left ventricular dysfunction should include assessment of coronary artery origins and course. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. CT or magnetic resonance angiography is useful as the initial screening method. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3. Surgical coronary revascularization should be performed in patients with any of the following indications: \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">a. Anomalous LMCA coursing between the Ao and PA. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">b. Documented ischemia due to coronary compression (when coursing between the great arteries or in intramural fashion). \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">c. Anomalous origin of the RCA between the Ao and PA with evidence of ischemia. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">B \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Class IIa</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Surgical coronary revascularization can be beneficial in the setting of documented vascular wall hypoplasia, coronary compression or obstruction to coronary flow, regardless of inability to document coronary ischemia. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2. Delineation of potential mechanisms of flow restriction via intravascular ultrasound can be beneficial in patients with documented anomalous coronary artery origin from the opposite sinus. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"></td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="2" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Class IIb</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1. Surgical coronary revascularization may be reasonable in patients with anomalous LAD coursing between the Ao and PA. \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">C \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355058.png" ] ] ] ] "descripcion" => array:1 [ "en" => "American College of Cardiology/American Heart Association recommendations.<a class="elsevierStyleCrossRef" href="#bib0120">24</a>" ] ] 10 => array:7 [ "identificador" => "tbl0025" "etiqueta" => "Table 5" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "Ao: aorta; CAD: coronary artery disease; Cx: circumflex artery; F: female; HCM: hypertrophic cardiomyopathy; LA: left atrium; LCA: left coronary artery; M: male; PA: pulmonary artery." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Patient \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Anomaly \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Gender/age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Other diagnoses \t\t\t\t\t\t\n \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the LCA in the right coronary sinus coursing between the Ao and PA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M/53 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Significant CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus coursing between the Ao and PA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M/58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">HCMNon-significant CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus coursing between the Ao and PA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M/77 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-significant CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Single RCA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F/76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the Cx from the proximal RCA coursing between the Ao and the LA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">M/58 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-significant CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F/59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Anomalous origin of the LCA in the non-coronary sinus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F/49 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Separate ostia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F/47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Separate ostia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">F/72 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Non-significant CAD \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab355056.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Coronary artery anomalies observed." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anomalies of coronary arteries and their clinical significance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.W. Alexander" 1 => "G.C. Griffith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "1956" "volumen" => "14" "paginaInicial" => "800" "paginaFinal" => "805" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13374855" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary anomalies: incidence and importance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Cieslinski" 1 => "B. Rapprich" 2 => "G. Kober" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Cardiol" "fecha" => "1993" "volumen" => "16" "paginaInicial" => "711" "paginaFinal" => "715" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8222383" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary artery anomalies – current clinical issues definitions, classification, incidence, clinical relevance, and treatment guidelines" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Angelini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Tex Heart Inst J" "fecha" => "2002" "volumen" => "29" "paginaInicial" => "271" "paginaFinal" => "278" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12484611" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normal and anomalous coronary arteries in humans" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "P. Angelini" 1 => "S. Villason" 2 => "A.V. Chan" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Coronary artery anomalies: a comprehensive approach" "paginaInicial" => "27" "paginaFinal" => "150" "serieFecha" => "1999" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Normal and anomalous coronary arteries: definitions and classification" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Angelini" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am Heart J" "fecha" => "1989" "volumen" => "117" "paginaInicial" => "418" "paginaFinal" => "434" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2644796" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "B.J. Maron" 1 => "K.P. Carney" 2 => "H.M. Lever" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2003" "volumen" => "41" "paginaInicial" => "974" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12651044" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary artery anomalies: an entity in search of an identity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Angelini" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.106.618082" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2007" "volumen" => "115" "paginaInicial" => "1296" "paginaFinal" => "1305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17353457" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital heart surgery nomenclature and database project: anomalies of the coronary arteries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Dodge-Khatami" 1 => "C. Mavroudis" 2 => "C.L. Backer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Ann Thorac Surg" "fecha" => "2000" "volumen" => "69" "paginaInicial" => "270" "paginaFinal" => "297" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary anomalies: incidence, pathophysiology and clinical relevance" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "P. Angelini" 1 => "J.A. Velasco" 2 => "S. Flamm" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2002" "volumen" => "105" "paginaInicial" => "2449" "paginaFinal" => "2454" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12021235" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A systematic overview of anomalous coronary anatomy and an examination of the association with sudden cardiac death" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E.C. Lorenz" 1 => "F. Mookadam" 2 => "M. Mookadam" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Cardiovasc Med" "fecha" => "2006" "volumen" => "7" "paginaInicial" => "205" "paginaFinal" => "213" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17224864" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sudden cardiac death associated with isolated congenital coronary artery anomalies" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A.J. Taylor" 1 => "K.M. Rogan" 2 => "R. Virmani" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "1992" "volumen" => "20" "paginaInicial" => "640" "paginaFinal" => "647" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1512344" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Distribution and anomalies of coronary arteries in tetralogy of Fallot" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R.P. Dabizzi" 1 => "G. Caprioli" 2 => "L. Aiazzi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Circulation" "fecha" => "1980" "volumen" => "61" "paginaInicial" => "95" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7349946" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coronary artery anatomy and transposition of the great arteries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "G. Wernovsky" 1 => "S.P. Sanders" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Coron Artery Dis" "fecha" => "1993" "volumen" => "4" "paginaInicial" => "148" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8269206" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Anomalous aortic origin of a coronary artery with an interarterial course: should family screening be routine?" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J.A. Brothers" 1 => "P. Stephens" 2 => "J.W. Gaynor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jacc.2008.01.052" "Revista" => array:6 [ "tituloSerie" => "J Am Coll Cardiol" "fecha" => "2008" "volumen" => "51" "paginaInicial" => "2062" "paginaFinal" => "2064" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18498963" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Transthoracic echocardiography for imaging of the different coronary artery segments: a feasibility study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "J. Vegsundvåg" 1 => "E. Holte" 2 => "R. Wiseth" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1186/1476-7120-7-58" "Revista" => array:5 [ "tituloSerie" => "Cardiovasc Ultrasound" "fecha" => "2009" "volumen" => "7" "paginaInicial" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20028530" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Usefulness of transoesophageal echocardiography in showing the route of anomalous coronary arteries" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "T. Vicente" 1 => "J. López" 2 => "M. Valdés" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Heart" "fecha" => "1996" "volumen" => "75" "paginaInicial" => "183" "paginaFinal" => "184" ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multislice CT imaging of anomalous coronary arteries" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H. Shi" 1 => "A.J. Aschoff" 2 => "H.J. Brambs" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-004-2490-2" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2004" "volumen" => "14" "paginaInicial" => "2172" "paginaFinal" => "2181" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15490179" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of congenital coronary anomalies with multislice computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.R. Deibler" 1 => "R.S. Kuzo" 2 => "M. Vöhringer" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Mayo Clin Proc" "fecha" => "2004" "volumen" => "79" "paginaInicial" => "1017" "paginaFinal" => "1023" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15301329" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Congenital anomalies of the coronary arteries: imaging with contrast-enhanced, multidetector computed tomography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Schmitt" 1 => "S. Froehner" 2 => "J. Brunn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00330-005-2707-z" "Revista" => array:6 [ "tituloSerie" => "Eur Radiol" "fecha" => "2005" "volumen" => "15" "paginaInicial" => "1110" "paginaFinal" => "1121" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756551" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "D. Ropers" 1 => "W. Moshage" 2 => "W.G. Daniel" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Am J Cardiol" "fecha" => "2001" "volumen" => "87" "paginaInicial" => "193" "paginaFinal" => "197" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11152838" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Artéria coronária direita única" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "R. Dourado" 1 => "M. Pacheco" 2 => "A. Lopes" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2010" "volumen" => "29" "paginaInicial" => "1891" "paginaFinal" => "1893" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21428145" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ACCF/SCCT/ACR/AHA/ASE/ASNC/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography, A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, the Society of Cardiovascular Computed Tomography, the American College of Radiology, the American Heart Association, the American Society of Echocardiography, the American Society of Nuclear Cardiology, the North American Society for Cardiovascular Imaging, the Society for Cardiovascular Angiography and Interventions, and the Society for Cardiovascular Magnetic Resonance" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "A.J. Taylor" 1 => "M. Cerqueira" 2 => "J.M. Hodgson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIR.0b013e3181fcae66" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2010" "volumen" => "122" "paginaInicial" => "e525" "paginaFinal" => "e555" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20975004" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.V. McConnell" 1 => "P. Ganz" 2 => "A.P. Selwyn" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "1995" "volumen" => "92" "paginaInicial" => "3158" "paginaFinal" => "3162" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7586298" "web" => "Medline" ] ] ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease)" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "C.A. Warnes" 1 => "R.G. Williams" 2 => "T.M. Bashore" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1161/CIRCULATIONAHA.108.190690" "Revista" => array:6 [ "tituloSerie" => "Circulation" "fecha" => "2008" "volumen" => "118" "paginaInicial" => "e714" "paginaFinal" => "e833" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18997169" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "ESC Guidelines for the management of grown-up congenital heart disease (new version 2010). The Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "H. Baumgartner" 1 => "P. Bonhoeffer" 2 => "N. De Groot" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/eurheartj/ehq249" "Revista" => array:7 [ "tituloSerie" => "Eur Heart J" "fecha" => "2010" "volumen" => "31" "numero" => "23" "paginaInicial" => "2915" "paginaFinal" => "2957" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20801927" "web" => "Medline" ] ] ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prevalência de anomalias na origem e trajecto das artérias coronárias em população portuguesa não selecionada: estudo retrospectivo" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "E. Correia" 1 => "P. Ferreira" 2 => "B. Rodrigues" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2010" "volumen" => "29" "paginaInicial" => "221" "paginaFinal" => "229" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20545249" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0135" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Percentagem de Anomalias Coronárias numa População de Doentes Submetidos a Angiografia – Estudo Retrospectivo" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "M.J. Correia" 1 => "J.L. Faria" 2 => "P.P. Cardoso" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Port Cardiol" "fecha" => "2004" "volumen" => "23" "paginaInicial" => "671" "paginaFinal" => "681" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15279452" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:3 [ "identificador" => "xack54272" "titulo" => "Acknowledgements" "texto" => "The authors thank Dr. Pedro Gonçalves (Hospital da Luz) and Dr. Nuno Bettencourt (Centro Hospitalar de Vila Nova de Gaia) for their help with the cardiac CT angiographic studies." ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912000955/v1_201308021407/en/main.assets" "Apartado" => array:4 [ "identificador" => "9917" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original Articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003100000078/v1_201308021407/S2174204912000955/v1_201308021407/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912000955?idApp=UINPBA00004E"]

Statistics

Original article

Coronary artery anomalies

Anomalias das artérias coronárias

Carla Almeida

Corresponding author

correio.carla@gmail.com

Corresponding author.

, Raquel Dourado, Carina Machado, Emília Santos, Nuno Pelicano, Miguel Pacheco, Anabela Tavares, Fernando Melo, Manuela Matos, José Vieira Faria, Dinis Martins

Serviço de Cardiologia, Hospital Divino Espírito Santo, EPE de Ponta Delgada, Ponta Delgada, Açores, Portugal

Read

10723

Times
was read the article

2104

Total PDF

8619

Total HTML

Share statistics

 array:24 [
  "pii" => "S2174204912000955"
  "issn" => "21742049"
  "doi" => "10.1016/j.repce.2011.12.018"
  "estado" => "S300"
  "fechaPublicacion" => "2012-07-01"
  "aid" => "113"
  "copyright" => "Sociedade Portuguesa de Cardiologia"
  "copyrightAnyo" => "2010"
  "documento" => "article"
  "crossmark" => 0
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "fla"
  "cita" => "Rev Port Cardiol. 2012;31:477-84"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:2 [
    "total" => 6852
    "formatos" => array:3 [
      "EPUB" => 134
      "HTML" => 5917
      "PDF" => 801
    ]
  ]
  "itemSiguiente" => array:19 [
    "pii" => "S2174204912001201"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2012.01.017"
    "estado" => "S300"
    "fechaPublicacion" => "2012-07-01"
    "aid" => "114"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "sco"
    "cita" => "Rev Port Cardiol. 2012;31:485-92"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 4353
      "formatos" => array:3 [
        "EPUB" => 160
        "HTML" => 3498
        "PDF" => 695
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case report</span>"
      "titulo" => "Are intraventricular gradients a cause of false positive treadmill exercise tests&#63;"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "485"
          "paginaFinal" => "492"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "Ser&#227;o os gradientes intraventriculares uma causa de falsos positivos de prova de esfor&#231;o&#63;"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1211
              "Ancho" => 1646
              "Tamanyo" => 132738
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patient 8&#58; echocardiographic findings in Table 2&#46; Intraventricular gradient of 100&#46;54<span class="elsevierStyleHsp" style=""></span>mmHg with a biphasic wave and late systolic peak detected during DSE at a heart rate of 161<span class="elsevierStyleHsp" style=""></span>bpm&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Nuno Cardim, Pedro Campos, Daniel Ferreira, Vanda Carmelo, J&#250;lia Toste, Marisa Trabulo, Teresa Santos, Sylvie da Mariana, Francisco Pereira Machado, Jos&#233; Roquette"
          "autores" => array:10 [
            0 => array:2 [
              "nombre" => "Nuno"
              "apellidos" => "Cardim"
            ]
            1 => array:2 [
              "nombre" => "Pedro"
              "apellidos" => "Campos"
            ]
            2 => array:2 [
              "nombre" => "Daniel"
              "apellidos" => "Ferreira"
            ]
            3 => array:2 [
              "nombre" => "Vanda"
              "apellidos" => "Carmelo"
            ]
            4 => array:2 [
              "nombre" => "J&#250;lia"
              "apellidos" => "Toste"
            ]
            5 => array:2 [
              "nombre" => "Marisa"
              "apellidos" => "Trabulo"
            ]
            6 => array:2 [
              "nombre" => "Teresa"
              "apellidos" => "Santos"
            ]
            7 => array:2 [
              "nombre" => "Sylvie"
              "apellidos" => "da Mariana"
            ]
            8 => array:2 [
              "nombre" => "Francisco"
              "apellidos" => "Pereira Machado"
            ]
            9 => array:2 [
              "nombre" => "Jos&#233;"
              "apellidos" => "Roquette"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912001201?idApp=UINPBA00004E"
    "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912001201/v1_201308021407/en/main.assets"
  ]
  "itemAnterior" => array:19 [
    "pii" => "S2174204912000980"
    "issn" => "21742049"
    "doi" => "10.1016/j.repce.2011.12.020"
    "estado" => "S300"
    "fechaPublicacion" => "2012-07-01"
    "aid" => "116"
    "copyright" => "Sociedade Portuguesa de Cardiologia"
    "documento" => "article"
    "crossmark" => 0
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "fla"
    "cita" => "Rev Port Cardiol. 2012;31:469-76"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:2 [
      "total" => 5623
      "formatos" => array:3 [
        "EPUB" => 158
        "HTML" => 4681
        "PDF" => 784
      ]
    ]
    "en" => array:13 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
      "titulo" => "Tilt training increases vasoconstrictor reserve in patients with neurocardiogenic syncope"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "tieneResumen" => array:2 [
        0 => "en"
        1 => "pt"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "469"
          "paginaFinal" => "476"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "pt" => array:1 [
          "titulo" => "O treino de ortostatismo &#40;tilt training&#41; aumenta a reserva vasoconstritora em doentes com s&#237;ncope reflexa neurocardiog&#233;nica"
        ]
      ]
      "contieneResumen" => array:2 [
        "en" => true
        "pt" => true
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 2785
              "Ancho" => 2493
              "Tamanyo" => 293102
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Changes in hemodynamic variables between the first and the ninth tilt training sessions&#46; Note changes in response leading to improved adaptation&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "S&#233;rgio Laranjo, M&#225;rio Martins Oliveira, Cristiano Tavares, Vera Geraldes, Sofia Santos, Eunice Oliveira, Rui Ferreira, Isabel Rocha"
          "autores" => array:8 [
            0 => array:2 [
              "nombre" => "S&#233;rgio"
              "apellidos" => "Laranjo"
            ]
            1 => array:2 [
              "nombre" => "M&#225;rio Martins"
              "apellidos" => "Oliveira"
            ]
            2 => array:2 [
              "nombre" => "Cristiano"
              "apellidos" => "Tavares"
            ]
            3 => array:2 [
              "nombre" => "Vera"
              "apellidos" => "Geraldes"
            ]
            4 => array:2 [
              "nombre" => "Sofia"
              "apellidos" => "Santos"
            ]
            5 => array:2 [
              "nombre" => "Eunice"
              "apellidos" => "Oliveira"
            ]
            6 => array:2 [
              "nombre" => "Rui"
              "apellidos" => "Ferreira"
            ]
            7 => array:2 [
              "nombre" => "Isabel"
              "apellidos" => "Rocha"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912000980?idApp=UINPBA00004E"
    "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912000980/v1_201308021407/en/main.assets"
  ]
  "en" => array:21 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>"
    "titulo" => "Coronary artery anomalies"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "477"
        "paginaFinal" => "484"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Carla Almeida, Raquel Dourado, Carina Machado, Em&#237;lia Santos, Nuno Pelicano, Miguel Pacheco, Anabela Tavares, Fernando Melo, Manuela Matos, Jos&#233; Vieira Faria, Dinis Martins"
        "autores" => array:11 [
          0 => array:4 [
            "nombre" => "Carla"
            "apellidos" => "Almeida"
            "email" => array:1 [
              0 => "correio&#46;carla&#64;gmail&#46;com"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "Raquel"
            "apellidos" => "Dourado"
          ]
          2 => array:2 [
            "nombre" => "Carina"
            "apellidos" => "Machado"
          ]
          3 => array:2 [
            "nombre" => "Em&#237;lia"
            "apellidos" => "Santos"
          ]
          4 => array:2 [
            "nombre" => "Nuno"
            "apellidos" => "Pelicano"
          ]
          5 => array:2 [
            "nombre" => "Miguel"
            "apellidos" => "Pacheco"
          ]
          6 => array:2 [
            "nombre" => "Anabela"
            "apellidos" => "Tavares"
          ]
          7 => array:2 [
            "nombre" => "Fernando"
            "apellidos" => "Melo"
          ]
          8 => array:2 [
            "nombre" => "Manuela"
            "apellidos" => "Matos"
          ]
          9 => array:2 [
            "nombre" => "Jos&#233;"
            "apellidos" => "Vieira Faria"
          ]
          10 => array:2 [
            "nombre" => "Dinis"
            "apellidos" => "Martins"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Servi&#231;o de Cardiologia&#44; Hospital Divino Esp&#237;rito Santo&#44; EPE de Ponta Delgada&#44; Ponta Delgada&#44; A&#231;ores&#44; Portugal"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "pt" => array:1 [
        "titulo" => "Anomalias das art&#233;rias coron&#225;rias"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1455
            "Ancho" => 1333
            "Tamanyo" => 274157
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Absence of LMVA&#44; anterior descending and circumflex with separate ostia in 3D volume-rendered reconstruction &#40;A&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Coronary artery anomalies &#40;CAAs&#41; are congenital alterations in the origin&#44; course or structure of the epicardial coronary arteries&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The true incidence of CAAs in the general population has yet to be determined&#44; published series reporting very different percentages&#46; Alexander and Griffith<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> found an incidence of 0&#46;3&#37; in 1956&#44; based on autopsy studies&#46; In 1993&#44; Cieslinski et al&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> reported an incidence of 0&#46;97&#37; in 4016 patients undergoing angiography between 1985 and 1989&#46; However&#44; these figures do not reflect the true incidence of CAAs in the general population&#44; since autopsy studies are not performed as a matter of routine but for legal purposes&#44; and angiography was performed in a selected group of patients in the latter study&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">In 2002&#44; Angelini<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> found an incidence of around 1&#37; in the general population&#44; while a previous prospective analysis by the same author of 1950 patients undergoing cardiac computed tomography &#40;CT&#41; angiography reported an incidence of 5&#46;64&#37;&#44;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> much higher than in previous studies&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">By definition&#44; CAAs occur in less than 1&#37; of the general population&#44;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> alterations with a higher incidence being considered variants of normal&#46; No evidence has been found of differences in incidence according to gender or ethnicity&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Despite this uncertainty as to the true incidence of CAAs in the general population&#44; there is evidence of higher incidence among young athletes and members of the armed forces who have suffered sudden cardiac death&#46; In a registry of sudden death in athletes aged under 35 years&#44; in whom cardiovascular disease was the demonstrated cause of death on autopsy&#44; anomalous origin of a coronary artery in the opposite coronary sinus was responsible in 13&#37; of cases&#44; second only to hypertrophic cardiomyopathy&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> This illustrates the impact that strenuous physical activity can have on prognosis in these patients&#44; and makes the true incidence of CAAs an issue of public health rather than of mere academic interest&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">The authors review the literature and present a study on the incidence of CAAs in a population of patients undergoing cardiac CT angiography&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Classification</span><p id="par0035" class="elsevierStylePara elsevierViewall">There is no consensus on the classification of CAAs&#46; The principle behind the system proposed by Angelini<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; is that the denomination of an artery is determined by the territory it supplies rather than by its origin or initial course&#46; Thus&#44; the right coronary artery &#40;RCA&#41; is the vessel that provides blood flow to the right ventricular &#40;RV&#41; free wall&#44; the left anterior descending artery &#40;LAD&#41; provides blood flow to the anterior interventricular septum&#44; and the circumflex artery &#40;Cx&#41; provides blood flow to the left ventricular &#40;LV&#41; free wall&#44; on the obtuse margin of the heart&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">According to the same author&#44; the following are considered normal features of the coronary anatomy&#58; 2&#8211;4 ostia&#44; located in the right and left coronary sinuses&#44; with proximal orientation 45&#8211;90&#176; to the wall of the aorta&#59; the presence of a single common stem or trunk&#44; the left main coronary artery &#40;LMCA&#41; &#40;giving rise to the LAD and Cx&#41;&#59; a direct proximal course&#44; from ostium to destination&#59; a subepicardial mid course&#44; with adequate branches for the dependent myocardium&#44; and terminating in capillaries&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Other authors have proposed classifying CAAs as severe&#44; malignant or major versus minor&#44; depending on their hemodynamic and clinical significance&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">Regarding the incidence of the different anomalies&#44; in the prospective analysis of 1950 patients undergoing CT angiography&#44; Angelini<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> found the incidences shown in <a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pathophysiology and clinical presentation</span><p id="par0055" class="elsevierStylePara elsevierViewall">While most CAAs are asymptomatic&#44; clinical presentation in adults as a result of myocardial ischemia can be in the form of angina&#44; arrhythmias&#44; syncope&#44; infarction or sudden death&#46; The latter is generally triggered by strenuous physical activity<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Of the various CAAs&#44; origin of the LMCA in the right coronary sinus or of the RCA in the left sinus is associated with greater risk of sudden death&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">10&#44;11</span></a> This is because such anomalies can lead to an acute angle in the artery&#39;s initial course or an interarterial course between the aorta and the pulmonary artery &#40;PA&#41;&#44; which dilate during exercise and compress the coronary artery&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">CAAs can occur in isolation or be associated with other congenital disease&#44; including transposition of the great vessels&#44; tetralogy of Fallot and some forms of pulmonary atresia&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">12&#44;13</span></a> In such cases&#44; symptoms usually appear earlier and the diagnosis is made before adulthood&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">To date no genetic mutations have been linked to CAAs&#46; However&#44; an article<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">14</span></a> published in 2008 identified five cases of CAAs during screening of patients&#8217; relatives&#59; the authors highlight the need for further research in this area&#44; given the malignant nature of some of these anomalies&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Diagnosis and screening</span><p id="par0075" class="elsevierStylePara elsevierViewall">Diagnosing CAAs is a challenge&#44; since patients are usually asymptomatic and physical examination reveals no abnormalities&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Given the fatal prognosis of certain CAAs&#44; there is a need to develop screening methods&#44; ideally noninvasive&#44; as well as to define the target population&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">As CAAs are the second leading cause of sudden death in young athletes&#44; there is general agreement that a screening protocol should be established for young competitive athletes and those engaged in strenuous physical activity&#46; The most appropriate diagnostic exams have yet to be defined&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Electrocardiogram&#47;exercise testing&#47;Holter monitoring</span><p id="par0090" class="elsevierStylePara elsevierViewall">There are no specific electrocardiographic alterations that indicate a diagnosis of CAA&#46; The presence of abnormalities suggestive of ischemia or cardiac arrhythmia in children or young adults can raise suspicion and prompt other diagnostic exams&#46;</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Echocardiography</span><p id="par0095" class="elsevierStylePara elsevierViewall">Echocardiography is an attractive screening method since it is noninvasive&#44; widely available&#44; inexpensive and does not involve ionizing radiation&#46; However&#44; studies have reported variable sensitivity in diagnosing CAAs&#59; the exam is dependent on the expertise of the operator&#44; the age of the patient and the anomaly involved&#44; transthoracic echocardiography gives better results in children than in adults&#44; and the left coronary artery &#40;LCA&#41; is easier to identify than the RCA&#46;<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">15</span></a></p><p id="par0100" class="elsevierStylePara elsevierViewall">Transesophageal echocardiography has greater sensitivity in detecting CAAs and can define their proximal course and flow pattern&#44; but it is nevertheless a semi-invasive procedure&#46;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Invasive coronary angiography</span><p id="par0105" class="elsevierStylePara elsevierViewall">Conventional coronary angiography has been considered the gold standard method for diagnosing CAAs&#46; However&#44; it is an invasive exam and requires the use of nephrotoxic contrast agents and ionizing radiation&#46; Furthermore&#44; new imaging techniques&#44; particularly cardiac CT angiography and magnetic resonance imaging &#40;MRI&#41;&#44; that provide three-dimensional assessment of the origin and course of arteries and their relationship to adjacent structures&#44; have revealed certain shortcomings of invasive coronary angiography for the diagnosis of CAAs&#46;<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a></p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Noninvasive coronary assessment by CT angiography and MRI</span><p id="par0110" class="elsevierStylePara elsevierViewall">Noninvasive coronary assessment by CT angiography has evolved considerably in recent years&#46; It is now a widely used method of assessing the coronary arteries&#44; both for detecting atherosclerotic disease and identifying anomalies of origin or course&#44; and several studies have demonstrated its accuracy for the latter purpose&#46;<a class="elsevierStyleCrossRefs" href="#bib0090"><span class="elsevierStyleSup">18&#8211;20</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">Cardiac CT angiography provides better characterization of the origin of coronary arteries when selective characterization of the vessels is difficult&#44; or even impossible&#44; by invasive coronary angiography&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">21</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">The American Heart Association considers cardiac CT angiography an appropriate technique for diagnosis of CAAs&#44; awarding it a score of 9&#44; the maximum for a diagnostic method for a particular purpose&#46;<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Recent advances in cardiac CT angiography have enabled more and better information to be obtained&#44; while requiring ever smaller radiation doses&#44; which overcomes an important disadvantage of its use compared to cardiac MRI&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Magnetic resonance coronary angiography is a noninvasive method that has advantages over cardiac CT angiography and conventional coronary angiography&#44; namely that it does not require the use of nephrotoxic contrast agents or ionizing radiation&#46;<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> Its disadvantages are lengthy acquisition time and the fact that it is not widely available&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">Both CT angiography and cardiac MRI require a degree of collaboration on the part of the patient&#44; notably the ability to perform a breath-hold&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">In the ACC&#47;AHA 2008 guidelines for the management of adults with congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> cardiac CT angiography and cardiac MRI have a class I recommendation&#44; level of evidence B&#44; for the diagnosis of CAAs&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Given that CT angiography is more widely available than cardiac MRI and that it provides better definition than conventional angiography of the origin and course of coronary arteries and their relationship to other anatomical structures&#44; it appears to be the method of choice in most cases of suspected CAA&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The initial approach in symptomatic patients should be a 12-lead electrocardiogram&#44; exercise test and echocardiogram&#44; which can suggest the diagnosis in some cases or reveal another cause of symptoms&#46; Cardiac CT angiography should then be performed&#46; Cardiac MRI&#44; which has less potentially harmful effects&#44; may have a role in screening asymptomatic individuals&#44; particularly athletes&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Treatment</span><p id="par0155" class="elsevierStylePara elsevierViewall">The European Society of Cardiology guidelines for the management of grown-up congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> do not cover the treatment of patients with CAAs&#46; In the ACC&#47;AHA 2008 guidelines for the management of adults with congenital heart disease<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#44; surgical revascularization is indicated in cases of the LMCA originating in the right coronary sinus and coursing between the aorta and PA &#40;class I recommendation&#44; level of evidence B&#41; and of anomalies with an interarterial course with evidence of ischemia &#40;class I recommendation&#44; level of evidence B&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Objective</span><p id="par0160" class="elsevierStylePara elsevierViewall">To assess the incidence of CAA in a population of patients undergoing cardiac CT angiography&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Methods</span><p id="par0165" class="elsevierStylePara elsevierViewall">We performed a retrospective study of 360 patients who underwent cardiac CT angiography in our institution between October 2009 and April 2011&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">The exams were performed on a 64-slice scanner &#40;Somatom Definition<span class="elsevierStyleSup">&#174;</span>&#44; Siemens Medical Solutions&#41;&#46;</p><p id="par0175" class="elsevierStylePara elsevierViewall">Patients with heart rate of over 65<span class="elsevierStyleHsp" style=""></span>bpm were medicated with 100<span class="elsevierStyleHsp" style=""></span>mg oral metoprolol one hour before the exam&#44; and all received sublingual nitroglycerin prior to image acquisition&#46;</p><p id="par0180" class="elsevierStylePara elsevierViewall">Demographic&#44; clinical and angiographic characteristics were studied&#46; CAAs were classified according to a modified version of the classification proposed by Angelini<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> &#40;intramyocardial courses not being considered anomalous&#41;&#46; Significant coronary artery disease was defined as the presence of atherosclerotic plaques causing &#62;50&#37; stenosis&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Results</span><p id="par0185" class="elsevierStylePara elsevierViewall">Of the 360 patients undergoing cardiac CT angiography&#44; 26 were excluded as images were not acquired&#44; of whom 23 presented a calcium score of &#62;1000 &#40;indicating a high probability of the images being uninterpretable or of significant coronary artery disease&#41; and three were unable to perform the breathhold&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">Of the 334 patients assessed&#44; 41&#37; were male and mean age was 59<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>14 years&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">Of this group&#44; nine presented CAAs&#44; an incidence of 2&#46;69&#37;&#46; Four patients were male&#44; and mean age was 61<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11 years&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">All patients were symptomatic &#40;chest pain&#41;&#46; The indications for cardiac CT angiography were inability to perform an exercise test in five patients&#44; inconclusive ischemia test in two &#40;one after myocardial perfusion scintigraphy and one after stress echocardiography&#41;&#44; assessment of stent patency in one&#44; and inability to selectively catheterize the coronary artery by conventional angiography in the other patient&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">The most prevalent risk factors were hypertension &#40;77&#46;8&#37;&#44; seven patients&#41; and dyslipidemia &#40;55&#46;6&#37;&#44; five patients&#41;&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">The CAAs diagnosed &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41; were&#58; anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>&#41;&#59; two cases of anomalous origin of the RCA in the left coronary sinus coursing between the aorta and PA &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>&#41;&#59; anomalous origin of the LCA in the non-coronary sinus &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Figure 3</a>&#41;&#59; single RCA &#40;<a class="elsevierStyleCrossRef" href="#fig0025">Figure 5</a>&#41;&#59; anomalous origin of the RCA in the left coronary sinus &#40;benign variant&#41;&#59; anomalous origin of the Cx from the RCA coursing between the aorta and the left atrium &#40;<a class="elsevierStyleCrossRef" href="#fig0020">Figure 4</a>&#41;&#59; and two cases of separate ostia &#40;<a class="elsevierStyleCrossRef" href="#fig0030">Figure 6</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0025"></elsevierMultimedia><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><elsevierMultimedia ident="fig0020"></elsevierMultimedia><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0215" class="elsevierStylePara elsevierViewall">Four of these patients had non-significant CAD&#44; and one had significant coronary disease&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">All patients are currently under medical therapy&#59; one &#40;patient 1 &#8211; <a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41; is awaiting ischemia testing to guide therapeutic decision-making &#40;surgical revascularization or angioplasty&#41;&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discussion</span><p id="par0225" class="elsevierStylePara elsevierViewall">When classifying CAAs&#44; our group opted not to include intramyocardial courses&#44; as various studies have reported that these occur in more than 1&#37; of the population&#44; and are thus a variant of normal&#46; However&#44; this definition is prior to 2002&#44; and in the latest classification proposed by Angelini they are considered anomalies&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">The incidence of CAAs in our selected patient group was 2&#46;69&#37;&#44; higher than reported in the general population&#44; although it should be borne in mind that incidence in the general population was also based on selected patient groups&#44; namely those undergoing autopsy or invasive coronary angiography&#46;</p><p id="par0235" class="elsevierStylePara elsevierViewall">Two other Portuguese retrospective studies have been published to date&#44; of 3906<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a> and 3660<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">27</span></a> patients undergoing coronary angiography&#44; which found CAA prevalences of 0&#46;54&#37; and 0&#46;68&#37;&#44; respectively&#46;</p><p id="par0240" class="elsevierStylePara elsevierViewall">With regard to treatment&#44; only patients 1&#44; 2 and 3 &#40;<a class="elsevierStyleCrossRef" href="#tbl0025">Table 5</a>&#41; had CAAs with surgical indication according to the guidelines&#46; In the first case&#44; besides anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA&#44; a lesion causing 90&#37; stenosis was also detected in the distal Cx&#46; With a view to deciding the most appropriate treatment in this patient &#40;surgical revascularization or angioplasty&#41;&#44; stress echocardiography was performed to assess whether the ischemia causing the symptoms was in the territory of the LAD or of the Cx&#46; However&#44; the exam was inconclusive&#44; and the patient is awaiting myocardial perfusion scintigraphy&#46;</p><p id="par0245" class="elsevierStylePara elsevierViewall">In the second case&#44; the RCA had a subpulmonary course and so the patient was not considered for surgery&#59; in addition&#44; the patient&#39;s symptoms could also have been related to his hypertrophic cardiomyopathy&#46;</p><p id="par0250" class="elsevierStylePara elsevierViewall">The identification of CAAs associated with sudden death &#8211; anomalous origin of the LCA in the right coronary sinus coursing between the aorta and PA&#44; and single RCA &#8211; in older adults &#40;aged 77 and 76 years&#44; respectively&#41; makes these cases unusual&#59; the fact that these patients had not previously presented any ischemic complications casts doubt on the malignancy of their anomalies&#44; especially in the first case&#44; which was not treated surgically&#46;</p><p id="par0255" class="elsevierStylePara elsevierViewall">Our series included two cases of separate ostia &#40;absence of the LMCA&#41;&#46; While normally not considered a CAA&#44; it is included in the classification proposed by Angelini&#46; If included&#44; the incidence in our population was 2&#46;69&#37;&#44; if excluded the incidence falls to 2&#46;10&#37;&#46;</p><p id="par0260" class="elsevierStylePara elsevierViewall">There is currently no national registry of cardiac CT angiography in Portugal&#46; Such a registry could contribute to a better understanding of this and other heart diseases&#46;</p></span><span id="sec0070" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusions</span><p id="par0265" class="elsevierStylePara elsevierViewall">CAAs are rare and can be asymptomatic&#44; but they are nevertheless the second leading cause of death in apparently healthy young athletes&#46;</p><p id="par0270" class="elsevierStylePara elsevierViewall">There is ongoing debate concerning their incidence&#44; classification&#44; screening&#44; heritability and treatment&#46;</p><p id="par0275" class="elsevierStylePara elsevierViewall">The authors suggest the establishment of a national registry of cardiac CT angiography&#44; which would contribute to a better understanding of this and other cardiac diseases and enrich current knowledge about noninvasive cardiac imaging in Portugal&#46;</p></span><span id="sec0075" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicts of interest</span><p id="par0280" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:17 [
        0 => array:2 [
          "identificador" => "xres251789"
          "titulo" => "Abstract"
        ]
        1 => array:2 [
          "identificador" => "xpalclavsec239387"
          "titulo" => "Keywords"
        ]
        2 => array:2 [
          "identificador" => "xres251788"
          "titulo" => "Resumo"
        ]
        3 => array:2 [
          "identificador" => "xpalclavsec239386"
          "titulo" => "Palavras-chave"
        ]
        4 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Introduction"
        ]
        5 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Classification"
        ]
        6 => array:2 [
          "identificador" => "sec0015"
          "titulo" => "Pathophysiology and clinical presentation"
        ]
        7 => array:3 [
          "identificador" => "sec0020"
          "titulo" => "Diagnosis and screening"
          "secciones" => array:4 [
            0 => array:2 [
              "identificador" => "sec0025"
              "titulo" => "Electrocardiogram&#47;exercise testing&#47;Holter monitoring"
            ]
            1 => array:2 [
              "identificador" => "sec0030"
              "titulo" => "Echocardiography"
            ]
            2 => array:2 [
              "identificador" => "sec0035"
              "titulo" => "Invasive coronary angiography"
            ]
            3 => array:2 [
              "identificador" => "sec0040"
              "titulo" => "Noninvasive coronary assessment by CT angiography and MRI"
            ]
          ]
        ]
        8 => array:2 [
          "identificador" => "sec0045"
          "titulo" => "Treatment"
        ]
        9 => array:2 [
          "identificador" => "sec0050"
          "titulo" => "Objective"
        ]
        10 => array:2 [
          "identificador" => "sec0055"
          "titulo" => "Methods"
        ]
        11 => array:2 [
          "identificador" => "sec0060"
          "titulo" => "Results"
        ]
        12 => array:2 [
          "identificador" => "sec0065"
          "titulo" => "Discussion"
        ]
        13 => array:2 [
          "identificador" => "sec0070"
          "titulo" => "Conclusions"
        ]
        14 => array:2 [
          "identificador" => "sec0075"
          "titulo" => "Conflicts of interest"
        ]
        15 => array:2 [
          "identificador" => "xack54272"
          "titulo" => "Acknowledgements"
        ]
        16 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2010-07-22"
    "fechaAceptado" => "2012-01-25"
    "PalabrasClave" => array:2 [
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
          "identificador" => "xpalclavsec239387"
          "palabras" => array:3 [
            0 => "Coronary artery anomalies"
            1 => "64-Slice CT"
            2 => "Cardiac CT National Registry"
          ]
        ]
      ]
      "pt" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palavras-chave"
          "identificador" => "xpalclavsec239386"
          "palabras" => array:3 [
            0 => "Anomalias das art&#233;rias coron&#225;rias"
            1 => "Angio TC de 64 cortes"
            2 => "Registo Nacional das AngioTC Card&#237;acas"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronary artery anomalies &#40;CAAs&#41; are a rare entity but their true incidence in the general population has yet to be determined&#46; Most CAAs are asymptomatic&#44; but they are nevertheless the second leading cause of sudden death in apparently healthy young athletes&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The new imaging methods available to cardiologists&#44; including CT angiography and MRI&#44; now enable noninvasive diagnosis and characterization of these anomalies&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The authors review the literature and present a retrospective study of 360 consecutive patients who underwent cardiac CT angiography&#46; Demographic&#44; clinical and angiographic characteristics were studied&#46; The incidence of CAAs in this population was 2&#46;69&#37;&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">In order to better characterize this disorder&#44; including diagnostic strategy&#44; screening&#44; treatment and prognosis&#44; the authors suggest the establishment of a national registry of cardiac CT angiography&#46; Such a registry would fill the existing gap in information on exams performed in the country&#44; enriching current knowledge about this disease and noninvasive cardiac imaging in Portugal&#46;</p>"
      ]
      "pt" => array:2 [
        "titulo" => "Resumo"
        "resumen" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">As anomalias das art&#233;rias coron&#225;rias &#40;AAC&#41; s&#227;o uma entidade rara mas a sua verdadeira incid&#234;ncia na popula&#231;&#227;o em geral continua por definir&#46; A maioria das AAC s&#227;o assintom&#225;ticas&#44; no entanto&#44; constituem a segunda causa de morte s&#250;bita em jovens atletas&#44; aparentemente saud&#225;veis&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Os novos m&#233;todos de imagem ao dispor da Cardiologia&#44; nomeadamente a AngioTC e a RM&#44; permitem o diagn&#243;stico e a caracteriza&#231;&#227;o n&#227;o invasiva desta patologia&#46;</p><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Os autores fazem uma revis&#227;o da literatura e apresentam um estudo retrospectivo de 360 doentes consecutivos&#44; submetidos a AngioTC card&#237;aca&#46; Foram estudadas vari&#225;veis demogr&#225;ficas&#44; cl&#237;nicas e angiogr&#225;ficas&#46; Nesta popula&#231;&#227;o a incid&#234;ncia de AAC foi de 2&#44;69&#37;&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Para melhor caracteriza&#231;&#227;o desta patologia&#44; nomeadamente estrat&#233;gia diagn&#243;stica&#44; de rastreio&#44; terap&#234;utica e progn&#243;stico&#44; os autores sugerem a realiza&#231;&#227;o de um Registo Nacional das AngioTC card&#237;acas&#46; Este registo vai colmatar uma lacuna existente ao n&#237;vel da informa&#231;&#227;o dos exames realizados&#44; enriquecendo o conhecimento actual sobre a patologia e a imagiologia card&#237;aca n&#227;o invasiva em Portugal&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Please cite this article as&#58; Almeida&#44; C&#59; Anomalias das Art&#233;rias Coron&#225;rias&#46; Rev Port Cardiol 2012&#59;<span class="elsevierStyleBold">31&#40;7-8&#41;</span>&#58;477-484&#46;</p>"
      ]
    ]
    "multimedia" => array:11 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1007
            "Ancho" => 1667
            "Tamanyo" => 237689
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Anomalous origin of the LCA &#40;1&#41; in the right coronary sinus coursing between the aorta &#40;3&#41; and PA &#40;4&#41; in 3D volume-rendered reconstruction &#40;A&#41; and in axial view &#40;B&#41;&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "fig0010"
        "etiqueta" => "Figure 2"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr2.jpeg"
            "Alto" => 1015
            "Ancho" => 2500
            "Tamanyo" => 338457
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Anomalous origin of the RCA &#40;1&#41; in the left coronary sinus coursing between the aorta &#40;3&#41; and PA &#40;4&#41; in 3D volume-rendered reconstruction &#40;A and B&#41; and in axial view &#40;C&#41;&#46;</p>"
        ]
      ]
      2 => array:7 [
        "identificador" => "fig0015"
        "etiqueta" => "Figure 3"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr3.jpeg"
            "Alto" => 1232
            "Ancho" => 1667
            "Tamanyo" => 259109
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Anomalous origin of the LCA &#40;1&#41; in the non-coronary sinus&#44; in 3D volume-rendered reconstruction &#40;A&#41; and in axial view &#40;B&#41;&#46;</p>"
        ]
      ]
      3 => array:7 [
        "identificador" => "fig0020"
        "etiqueta" => "Figure 4"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr4.jpeg"
            "Alto" => 872
            "Ancho" => 1667
            "Tamanyo" => 174640
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Anomalous origin of the Cx &#40;1&#41; in the proximal RCA &#40;2&#41; coursing between the aorta &#40;3&#41; and left atrium &#40;5&#41; in 3D volume-rendered reconstruction &#40;A and B&#41;&#46;</p>"
        ]
      ]
      4 => array:7 [
        "identificador" => "fig0025"
        "etiqueta" => "Figure 5"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr5.jpeg"
            "Alto" => 1023
            "Ancho" => 1667
            "Tamanyo" => 270671
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Single RCA &#40;1&#41; in 3D volume-rendered reconstruction &#40;A and B&#41;&#46;</p>"
        ]
      ]
      5 => array:7 [
        "identificador" => "fig0030"
        "etiqueta" => "Figure 6"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr6.jpeg"
            "Alto" => 1455
            "Ancho" => 1333
            "Tamanyo" => 274157
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Absence of LMVA&#44; anterior descending and circumflex with separate ostia in 3D volume-rendered reconstruction &#40;A&#41;&#46;</p>"
        ]
      ]
      6 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Adapted from Angelini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>"
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Cx&#58; circumflex artery&#59; LAD&#58; left anterior descending artery&#59; LMCA&#58; left main coronary artery&#59; PA&#58; pulmonary artery&#59; RCA&#58; right coronary artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">A&#46; Anomalies of origin and course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; Absent LMCA &#40;split origin of LCA&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#46; Anomalous location of coronary ostium within aortic root or near proper aortic sinus of Valsalva for each artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; High&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; Low&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Commissural&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#46; Anomalous location of coronary ostium outside normal coronary aortic sinuses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; Right posterior aortic sinus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; Ascending aorta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Left ventricle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>d&#46; Right ventricle&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>e&#46; Pulmonary artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>f&#46; Aortic arch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>g&#46; Innominate artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>h&#46; Right carotid artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>i&#46; Internal mammary artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>j&#46; Bronchial artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>k&#46; Subclavian artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>l&#46; Descending thoracic aorta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4&#46; Anomalous location of coronary ostium in improper sinus &#8211; variants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; RCA arises from left coronary sinus&#44; with anomalous course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>i&#46; Posterior atrioventricular groove or retrocardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ii&#46; Retroaortic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iii&#46; Between aorta and PA &#40;intramural&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iv&#46; Intraseptal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>v&#46; Anterior to pulmonary outflow tract or precardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>vi&#46; Posteroanterior interventricular groove&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; LAD arises from right anterior sinus&#44; with anomalous course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>i&#46; Between aorta and PA &#40;intramural&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ii&#46; Intraseptal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iii&#46; Anterior to pulmonary outflow tract or precardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iv&#46; Posteroanterior interventricular groove&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Cx arises from right coronary sinus&#44; with anomalous course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>i&#46; Posterior atrioventricular groove&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ii&#46; Retroaortic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>d&#46; LMCA arises from right anterior sinus&#44; with anomalous course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>i&#46; Posterior atrioventricular groove or retrocardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>ii&#46; Retroaortic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iii&#46; Between aorta and PA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>iv&#46; Intraseptal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>v&#46; Anterior to pulmonary outflow tract or precardiac&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>vi&#46; Posteroanterior interventricular groove from Angelini et al&#46; 1999&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5&#46; Single coronary artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&#46; Anomalies of intrinsic coronary arterial anatomy&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; Congenital ostial stenosis or atresia &#40;LMCA&#44; LAD&#44; RCA&#44; Cx&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#46; Coronary ostial dimple&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#46; Coronary aneurysm or ectasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>4&#46; Absent coronary artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>5&#46; Coronary hypoplasia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>6&#46; Intramural coronary artery &#40;muscular bridge&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>7&#46; Subendocardial coronary course&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>8&#46; Coronary crossing&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>9&#46; Anomalous origin of posterior descending artery from the anterior descending branch or a septal penetrating branch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>10&#46; Split RCA &#8211; variants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; Proximal and distal posterior descending branches that both arise from the RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; Proximal posterior descending branch that arises from the RCA&#44; distal posterior descending branch that arises from the LAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Parallel posterior descending branches<span class="elsevierStyleHsp" style=""></span>&#215;<span class="elsevierStyleHsp" style=""></span>2 &#40;arising from RCA&#44; Cx&#41; or &#8220;codominant&#8221;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>11&#46; Split LAD &#8211; variants&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; LAD<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>first large septal branch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; LAD&#44; double &#40;parallel LADs&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>12&#46; Ectopic origin of first septal branch&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; Right sinus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Diagonal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>d&#46; Ramus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>e&#46; Cx&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&#46; Anomalies of coronary termination&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; Inadequate arteriolar&#47;capillary ramifications&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#46; Fistulas from RCA&#44; LMCA or infundibular artery&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">D&#46; Anomalous anastomotic vessels&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab355057.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Classification of coronary artery anomalies&#46;</p>"
        ]
      ]
      7 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Adapted from Angelini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>"
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">CAAs&#58; coronary artery anomalies&#59; Cx&#58; circumflex artery&#59; LCA&#58; left coronary artery&#59; RCA&#58; right coronary artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">CAAs&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;64&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Split RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ectopic RCA &#40;right cusp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ectopic RCA &#40;left cusp&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fistulas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;87&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Absent LCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Cx arising from right cusp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LCA arising from right cusp&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Low origin of RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Other anomalies&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab355055.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Incidence of CAAs in a series of 1950 CT angiograms&#46;</p>"
        ]
      ]
      8 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "fuente" => "Adapted from Angelini et al&#46;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a>"
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Group &#40;age&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">No&#46; of deaths&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Deaths related to coronary anomalies &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exercising individuals &#40;8&#8211;66 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">550&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">11&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">General population &#40;&#60;40 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">162&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Competitive athletes &#40;mean age&#58; 17 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">134&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Runners &#40;30&#8211;46 years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">120&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Exercising individuals&#44; Maryland&#44; USA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">62&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab355054.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Incidence of sudden death related to coronary artery anomalies&#46;</p>"
        ]
      ]
      9 => array:7 [
        "identificador" => "tbl0020"
        "etiqueta" => "Table 4"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Ao&#58; aorta&#59; LAD&#58; left anterior descending artery&#59; LMCA&#58; left main coronary artery&#59; PA&#58; pulmonary artery&#59; RCA&#58; right coronary artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Recommendation&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Level of evidence&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Class I</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; The evaluation of individuals who have survived unexplained aborted sudden cardiac death or with unexplained life-threatening arrhythmia&#44; coronary ischemic symptoms&#44; or left ventricular dysfunction should include assessment of coronary artery origins and course&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#46; CT or magnetic resonance angiography is useful as the initial screening method&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>3&#46; Surgical coronary revascularization should be performed in patients with any of the following indications&#58;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>a&#46; Anomalous LMCA coursing between the Ao and PA&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>b&#46; Documented ischemia due to coronary compression &#40;when coursing between the great arteries or in intramural fashion&#41;&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span><span class="elsevierStyleHsp" style=""></span>c&#46; Anomalous origin of the RCA between the Ao and PA with evidence of ischemia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">B&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Class IIa</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; Surgical coronary revascularization can be beneficial in the setting of documented vascular wall hypoplasia&#44; coronary compression or obstruction to coronary flow&#44; regardless of inability to document coronary ischemia&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>2&#46; Delineation of potential mechanisms of flow restriction via intravascular ultrasound can be beneficial in patients with documented anomalous coronary artery origin from the opposite sinus&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Class IIb</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1&#46; Surgical coronary revascularization may be reasonable in patients with anomalous LAD coursing between the Ao and PA&#46;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">C&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab355058.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">American College of Cardiology&#47;American Heart Association recommendations&#46;<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a></p>"
        ]
      ]
      10 => array:7 [
        "identificador" => "tbl0025"
        "etiqueta" => "Table 5"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0115" class="elsevierStyleSimplePara elsevierViewall">Ao&#58; aorta&#59; CAD&#58; coronary artery disease&#59; Cx&#58; circumflex artery&#59; F&#58; female&#59; HCM&#58; hypertrophic cardiomyopathy&#59; LA&#58; left atrium&#59; LCA&#58; left coronary artery&#59; M&#58; male&#59; PA&#58; pulmonary artery&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Patient&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Anomaly&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Gender&#47;age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Other diagnoses&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the LCA in the right coronary sinus coursing between the Ao and PA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#47;53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Significant CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus coursing between the Ao and PA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#47;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HCMNon-significant CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus coursing between the Ao and PA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#47;77&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-significant CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Single RCA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#47;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the Cx from the proximal RCA coursing between the Ao and the LA&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">M&#47;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-significant CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the RCA in the left coronary sinus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#47;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Anomalous origin of the LCA in the non-coronary sinus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#47;49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Separate ostia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#47;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Separate ostia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">F&#47;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Non-significant CAD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab355056.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0110" class="elsevierStyleSimplePara elsevierViewall">Coronary artery anomalies observed&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:27 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anomalies of coronary arteries and their clinical significance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46;W&#46; Alexander"
                            1 => "G&#46;C&#46; Griffith"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1956"
                        "volumen" => "14"
                        "paginaInicial" => "800"
                        "paginaFinal" => "805"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/13374855"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronary anomalies&#58; incidence and importance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "G&#46; Cieslinski"
                            1 => "B&#46; Rapprich"
                            2 => "G&#46; Kober"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Cardiol"
                        "fecha" => "1993"
                        "volumen" => "16"
                        "paginaInicial" => "711"
                        "paginaFinal" => "715"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8222383"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronary artery anomalies &#8211; current clinical issues definitions&#44; classification&#44; incidence&#44; clinical relevance&#44; and treatment guidelines"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Angelini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Tex Heart Inst J"
                        "fecha" => "2002"
                        "volumen" => "29"
                        "paginaInicial" => "271"
                        "paginaFinal" => "278"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12484611"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normal and anomalous coronary arteries in humans"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "P&#46; Angelini"
                            1 => "S&#46; Villason"
                            2 => "A&#46;V&#46; Chan"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "LibroEditado" => array:4 [
                        "titulo" => "Coronary artery anomalies&#58; a comprehensive approach"
                        "paginaInicial" => "27"
                        "paginaFinal" => "150"
                        "serieFecha" => "1999"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Normal and anomalous coronary arteries&#58; definitions and classification"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Angelini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am Heart J"
                        "fecha" => "1989"
                        "volumen" => "117"
                        "paginaInicial" => "418"
                        "paginaFinal" => "434"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/2644796"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "B&#46;J&#46; Maron"
                            1 => "K&#46;P&#46; Carney"
                            2 => "H&#46;M&#46; Lever"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2003"
                        "volumen" => "41"
                        "paginaInicial" => "974"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12651044"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib0035"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronary artery anomalies&#58; an entity in search of an identity"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "P&#46; Angelini"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.106.618082"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2007"
                        "volumen" => "115"
                        "paginaInicial" => "1296"
                        "paginaFinal" => "1305"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17353457"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital heart surgery nomenclature and database project&#58; anomalies of the coronary arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Dodge-Khatami"
                            1 => "C&#46; Mavroudis"
                            2 => "C&#46;L&#46; Backer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Ann Thorac Surg"
                        "fecha" => "2000"
                        "volumen" => "69"
                        "paginaInicial" => "270"
                        "paginaFinal" => "297"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronary anomalies&#58; incidence&#44; pathophysiology and clinical relevance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "P&#46; Angelini"
                            1 => "J&#46;A&#46; Velasco"
                            2 => "S&#46; Flamm"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2002"
                        "volumen" => "105"
                        "paginaInicial" => "2449"
                        "paginaFinal" => "2454"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12021235"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib0050"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A systematic overview of anomalous coronary anatomy and an examination of the association with sudden cardiac death"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46;C&#46; Lorenz"
                            1 => "F&#46; Mookadam"
                            2 => "M&#46; Mookadam"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Cardiovasc Med"
                        "fecha" => "2006"
                        "volumen" => "7"
                        "paginaInicial" => "205"
                        "paginaFinal" => "213"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17224864"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib0055"
              "etiqueta" => "11"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Sudden cardiac death associated with isolated congenital coronary artery anomalies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46;J&#46; Taylor"
                            1 => "K&#46;M&#46; Rogan"
                            2 => "R&#46; Virmani"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "1992"
                        "volumen" => "20"
                        "paginaInicial" => "640"
                        "paginaFinal" => "647"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1512344"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib0060"
              "etiqueta" => "12"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Distribution and anomalies of coronary arteries in tetralogy of Fallot"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46;P&#46; Dabizzi"
                            1 => "G&#46; Caprioli"
                            2 => "L&#46; Aiazzi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1980"
                        "volumen" => "61"
                        "paginaInicial" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7349946"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "13"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Coronary artery anatomy and transposition of the great arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46; Wernovsky"
                            1 => "S&#46;P&#46; Sanders"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Coron Artery Dis"
                        "fecha" => "1993"
                        "volumen" => "4"
                        "paginaInicial" => "148"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/8269206"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "14"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anomalous aortic origin of a coronary artery with an interarterial course&#58; should family screening be routine&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; Brothers"
                            1 => "P&#46; Stephens"
                            2 => "J&#46;W&#46; Gaynor"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.jacc.2008.01.052"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Am Coll Cardiol"
                        "fecha" => "2008"
                        "volumen" => "51"
                        "paginaInicial" => "2062"
                        "paginaFinal" => "2064"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18498963"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "15"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Transthoracic echocardiography for imaging of the different coronary artery segments&#58; a feasibility study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "J&#46; Vegsundv&#229;g"
                            1 => "E&#46; Holte"
                            2 => "R&#46; Wiseth"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1186/1476-7120-7-58"
                      "Revista" => array:5 [
                        "tituloSerie" => "Cardiovasc Ultrasound"
                        "fecha" => "2009"
                        "volumen" => "7"
                        "paginaInicial" => "58"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20028530"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "16"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Usefulness of transoesophageal echocardiography in showing the route of anomalous coronary arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "T&#46; Vicente"
                            1 => "J&#46; L&#243;pez"
                            2 => "M&#46; Vald&#233;s"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Heart"
                        "fecha" => "1996"
                        "volumen" => "75"
                        "paginaInicial" => "183"
                        "paginaFinal" => "184"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib0085"
              "etiqueta" => "17"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Multislice CT imaging of anomalous coronary arteries"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Shi"
                            1 => "A&#46;J&#46; Aschoff"
                            2 => "H&#46;J&#46; Brambs"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-004-2490-2"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2004"
                        "volumen" => "14"
                        "paginaInicial" => "2172"
                        "paginaFinal" => "2181"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15490179"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "18"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Imaging of congenital coronary anomalies with multislice computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;R&#46; Deibler"
                            1 => "R&#46;S&#46; Kuzo"
                            2 => "M&#46; V&#246;hringer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Mayo Clin Proc"
                        "fecha" => "2004"
                        "volumen" => "79"
                        "paginaInicial" => "1017"
                        "paginaFinal" => "1023"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15301329"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "19"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Congenital anomalies of the coronary arteries&#58; imaging with contrast-enhanced&#44; multidetector computed tomography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Schmitt"
                            1 => "S&#46; Froehner"
                            2 => "J&#46; Brunn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00330-005-2707-z"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur Radiol"
                        "fecha" => "2005"
                        "volumen" => "15"
                        "paginaInicial" => "1110"
                        "paginaFinal" => "1121"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15756551"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib0100"
              "etiqueta" => "20"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "D&#46; Ropers"
                            1 => "W&#46; Moshage"
                            2 => "W&#46;G&#46; Daniel"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Cardiol"
                        "fecha" => "2001"
                        "volumen" => "87"
                        "paginaInicial" => "193"
                        "paginaFinal" => "197"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11152838"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib0105"
              "etiqueta" => "21"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Art&#233;ria coron&#225;ria direita &#250;nica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "R&#46; Dourado"
                            1 => "M&#46; Pacheco"
                            2 => "A&#46; Lopes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "1891"
                        "paginaFinal" => "1893"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21428145"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib0110"
              "etiqueta" => "22"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ACCF&#47;SCCT&#47;ACR&#47;AHA&#47;ASE&#47;ASNC&#47;SCAI&#47;SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography&#44; A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force&#44; the Society of Cardiovascular Computed Tomography&#44; the American College of Radiology&#44; the American Heart Association&#44; the American Society of Echocardiography&#44; the American Society of Nuclear Cardiology&#44; the North American Society for Cardiovascular Imaging&#44; the Society for Cardiovascular Angiography and Interventions&#44; and the Society for Cardiovascular Magnetic Resonance"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "A&#46;J&#46; Taylor"
                            1 => "M&#46; Cerqueira"
                            2 => "J&#46;M&#46; Hodgson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIR.0b013e3181fcae66"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2010"
                        "volumen" => "122"
                        "paginaInicial" => "e525"
                        "paginaFinal" => "e555"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20975004"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib0115"
              "etiqueta" => "23"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;V&#46; McConnell"
                            1 => "P&#46; Ganz"
                            2 => "A&#46;P&#46; Selwyn"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "1995"
                        "volumen" => "92"
                        "paginaInicial" => "3158"
                        "paginaFinal" => "3162"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/7586298"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib0120"
              "etiqueta" => "24"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ACC&#47;AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease A Report of the American College of Cardiology&#47;American Heart Association Task Force on Practice Guidelines &#40;Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Warnes"
                            1 => "R&#46;G&#46; Williams"
                            2 => "T&#46;M&#46; Bashore"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1161/CIRCULATIONAHA.108.190690"
                      "Revista" => array:6 [
                        "tituloSerie" => "Circulation"
                        "fecha" => "2008"
                        "volumen" => "118"
                        "paginaInicial" => "e714"
                        "paginaFinal" => "e833"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18997169"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib0125"
              "etiqueta" => "25"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "ESC Guidelines for the management of grown-up congenital heart disease &#40;new version 2010&#41;&#46; The Task Force on the Management of Grown-up Congenital Heart Disease of the European Society of Cardiology"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "H&#46; Baumgartner"
                            1 => "P&#46; Bonhoeffer"
                            2 => "N&#46; De Groot"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/eurheartj/ehq249"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur Heart J"
                        "fecha" => "2010"
                        "volumen" => "31"
                        "numero" => "23"
                        "paginaInicial" => "2915"
                        "paginaFinal" => "2957"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20801927"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib0130"
              "etiqueta" => "26"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preval&#234;ncia de anomalias na origem e trajecto das art&#233;rias coron&#225;rias em popula&#231;&#227;o portuguesa n&#227;o selecionada&#58; estudo retrospectivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "E&#46; Correia"
                            1 => "P&#46; Ferreira"
                            2 => "B&#46; Rodrigues"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2010"
                        "volumen" => "29"
                        "paginaInicial" => "221"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20545249"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib0135"
              "etiqueta" => "27"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Percentagem de Anomalias Coron&#225;rias numa Popula&#231;&#227;o de Doentes Submetidos a Angiografia &#8211; Estudo Retrospectivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "M&#46;J&#46; Correia"
                            1 => "J&#46;L&#46; Faria"
                            2 => "P&#46;P&#46; Cardoso"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Port Cardiol"
                        "fecha" => "2004"
                        "volumen" => "23"
                        "paginaInicial" => "671"
                        "paginaFinal" => "681"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15279452"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
    "agradecimientos" => array:1 [
      0 => array:3 [
        "identificador" => "xack54272"
        "titulo" => "Acknowledgements"
        "texto" => "<p id="par0285" class="elsevierStylePara elsevierViewall">The authors thank Dr&#46; Pedro Gon&#231;alves &#40;Hospital da Luz&#41; and Dr&#46; Nuno Bettencourt &#40;Centro Hospitalar de Vila Nova de Gaia&#41; for their help with the cardiac CT angiographic studies&#46;</p>"
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/21742049/0000003100000078/v1_201308021407/S2174204912000955/v1_201308021407/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "9917"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Original Articles"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003100000078/v1_201308021407/S2174204912000955/v1_201308021407/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204912000955?idApp=UINPBA00004E"
]

Article information

ISSN: 21742049
Original language: English

DOI:10.1016/j.repce.2011.12.018

The statistics are updated each day

Year/Month	Html	Pdf	Total

2024 November	8	5	13
2024 October	73	30	103
2024 September	90	31	121
2024 August	59	24	83
2024 July	55	32	87
2024 June	53	23	76
2024 May	45	39	84
2024 April	42	22	64
2024 March	53	22	75
2024 February	54	35	89
2024 January	54	36	90
2023 December	47	32	79
2023 November	37	36	73
2023 October	36	25	61
2023 September	35	31	66
2023 August	36	19	55
2023 July	60	18	78
2023 June	56	15	71
2023 May	51	29	80
2023 April	34	4	38
2023 March	66	22	88
2023 February	53	18	71
2023 January	45	17	62
2022 December	43	21	64
2022 November	59	29	88
2022 October	44	14	58
2022 September	48	32	80
2022 August	47	32	79
2022 July	51	28	79
2022 June	39	15	54
2022 May	37	31	68
2022 April	45	24	69
2022 March	38	37	75
2022 February	38	26	64
2022 January	32	19	51
2021 December	29	24	53
2021 November	55	31	86
2021 October	45	36	81
2021 September	37	26	63
2021 August	25	35	60
2021 July	35	31	66
2021 June	34	21	55
2021 May	51	42	93
2021 April	70	33	103
2021 March	85	13	98
2021 February	52	8	60
2021 January	35	12	47
2020 December	27	5	32
2020 November	55	26	81
2020 October	35	10	45
2020 September	59	13	72
2020 August	24	14	38
2020 July	67	5	72
2020 June	38	13	51
2020 May	54	1	55
2020 April	45	14	59
2020 March	54	10	64
2020 February	129	39	168
2020 January	24	8	32
2019 December	40	5	45
2019 November	42	5	47
2019 October	37	11	48
2019 September	39	5	44
2019 August	41	8	49
2019 July	50	14	64
2019 June	46	10	56
2019 May	32	18	50
2019 April	29	20	49
2019 March	82	6	88
2019 February	52	10	62
2019 January	42	4	46
2018 December	41	9	50
2018 November	86	7	93
2018 October	206	16	222
2018 September	54	15	69
2018 August	47	24	71
2018 July	61	4	65
2018 June	79	7	86
2018 May	165	13	178
2018 April	151	4	155
2018 March	199	6	205
2018 February	72	6	78
2018 January	114	9	123
2017 December	157	6	163
2017 November	62	10	72
2017 October	45	13	58
2017 September	56	11	67
2017 August	47	16	63
2017 July	38	14	52
2017 June	38	19	57
2017 May	43	6	49
2017 April	26	1	27
2017 March	45	37	82
2017 February	65	3	68
2017 January	45	0	45
2016 December	59	9	68
2016 November	55	3	58
2016 October	50	6	56
2016 September	59	6	65
2016 August	28	1	29
2016 July	16	4	20
2016 June	17	1	18
2016 May	31	4	35
2016 April	51	5	56
2016 March	83	0	83
2016 February	85	13	98
2016 January	73	7	80
2015 December	70	4	74
2015 November	79	10	89
2015 October	80	9	89
2015 September	68	9	77
2015 August	95	4	99
2015 July	76	5	81
2015 June	50	6	56
2015 May	91	11	102
2015 April	63	11	74
2015 March	66	1	67
2015 February	83	1	84
2015 January	86	6	92
2014 December	82	6	88
2014 November	92	3	95
2014 October	87	2	89
2014 September	74	4	78
2014 August	61	5	66
2014 July	55	7	62
2014 June	58	5	63
2014 May	57	0	57
2014 April	66	4	70
2014 March	76	10	86
2014 February	67	5	72
2014 January	71	9	80
2013 December	61	9	70
2013 November	82	10	92
2013 October	66	4	70
2013 September	65	15	80
2013 August	58	17	75
2013 July	84	20	104
2013 June	74	12	86
2013 May	92	14	106
2013 April	68	19	87
2013 March	54	13	67
2013 February	59	18	77
2013 January	58	16	74
2012 December	61	11	72
2012 November	39	9	48
2012 October	29	3	32
2012 September	8	3	11

Show all

Indexed in:

Follow us:

Statistics

Indexed in:

Follow us:

Statistics

Subscribe to our newsletter