Image in cardiology
Single coronary artery with mesocardia, situs inversus, and atrioventricular and ventriculoarterial discordance
Artéria coronária única com mesocardia, situs inversus, discordância aurículo-ventrículo e ventrículo-arterial
Ricardo Duartea,
, Maria Ana Sampaiob, Humberto Moraisc, Constança Palmad, João Carlos Costaa, António Felipe Júniore
Corresponding author
a Serviço Diagnóstico por Imagem, Hospital Particular de Viana do Castelo, Viana do Castelo, Portugal e Serviço de Imagiologia, Clínica Girassol, Luanda, Angola
b Serviço de Cardiologia Pediátrica, Hospital da Cruz Vermelha, Lisboa, Portugal e Serviço de Cardiologia Pediátrica, Clínica Girassol, Luanda, Angola
c Serviço de Cardiologia, Hospital Militar Principal de Luanda, Luanda, Angola
d Serviço de Imagiologia, Clínica Girassol, Luanda, Angola
e Serviço de Cardiologia, Clínica Girassol, Luanda, Angola
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da Cruz Vermelha, Lisboa, Portugal e Serviço de Cardiologia Pediátrica, Clínica Girassol, Luanda, Angola" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Serviço de Cardiologia, Hospital Militar Principal de Luanda, Luanda, Angola" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Serviço de Imagiologia, Clínica Girassol, Luanda, Angola" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Serviço de Cardiologia, Clínica Girassol, Luanda, Angola" "etiqueta" => "e" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Artéria coronária única com mesocardia, <span class="elsevierStyleItalic">situs inversus</span>, discordância aurículo-ventrículo e ventrículo-arterial" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 1137 "Ancho" => 1028 "Tamanyo" => 126395 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Atrioventricular and ventriculoarterial discordance with a single coronary artery. Axial (A) and multiplanar (B, C and D) reconstructions showing atrioventricular and ventriculoarterial discordance, with anterior right aorta and posterior left pulmonary artery, infundibular septal defect with subarterial communication (asterisk), and anomalous origin of the right coronary artery in the left coronary sinus, coursing between the aorta and the pulmonary artery. AD: right atrium; AE: left atrium; Ao: aorta; CD: right coronary artery; Cx: circumflex artery; DA: anterior descending artery; P: pulmonary artery; VD: right ventricle; VE: left ventricle.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Congenital coronary artery anomalies affect therapeutic options when associated with congenital heart disease.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Echocardiography is the first-line exam for diagnosis and management of patients with congenital heart disease, but is less useful for anatomical assessment of the great vessels and the coronary arteries. Cardiac catheterization has a higher risk of complications due to its invasive nature, and since it is a two-dimensional technique, the anatomical information it provides is limited.</p><p id="par0015" class="elsevierStylePara elsevierViewall">In the last two decades, computed tomography (CT) and magnetic resonance imaging have become important non-invasive diagnostic tools that provide more accurate anatomical information than any other imaging modality.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The authors describe the CT findings in a 29-month-old boy referred for cardiac CT angiography to assess complex congenital heart disease. The study was performed on a 128-slice prospectively ECG-gated dual-source Siemens Definition Flash system and showed mesocardia with abdominal/atrial situs inversus (<a class="elsevierStyleCrossRef" href="#fig0005">Figure 1</a>), atrioventricular and ventriculoarterial discordance with a subpulmonary ventricular septal defect, and a single coronary artery (<a class="elsevierStyleCrossRef" href="#fig0010">Figure 2</a>). Effective radiation dose was 1.0 mSv (dose-length product 25 mGy.cm).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The patient was considered unsuitable for surgery due to the high surgical risk arising from the single coronary artery. This case illustrates the value of cardiac CT angiography for detailed non-invasive anatomical assessment of intra- and extracardiac structures, and was decisive in the therapeutic decision-making process.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicts of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">The authors have no conflicts of interest to declare.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:1 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflicts of interest" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2013-03-17" "fechaAceptado" => "2013-04-24" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Duarte R, Sampaio MA, Morais H, et al. Artéria coronária única com mesocardia, <span class="elsevierStyleItalic">situs inversus</span>, discordância aurículo-ventrículo e ventrículo-arterial 2013;32:837–838.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 723 "Ancho" => 1089 "Tamanyo" => 121670 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Mesocardia and situs inversus. (A) Topogram; (B) multiplanar reconstruction, coronal view; (C) axial image of the abdomen; (D) three-dimensional volume rendering showing mesocardia, morphological right bronchus in left position, morphological left bronchus in right position, liver on the left, stomach and spleen on the right, and anterior right aorta and posterior left pulmonary artery. Ao: aorta: B: spleen; E: stomach; F: liver; P: pulmonary artery.</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" => 1137 "Ancho" => 1028 "Tamanyo" => 126395 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Atrioventricular and ventriculoarterial discordance with a single coronary artery. Axial (A) and multiplanar (B, C and D) reconstructions showing atrioventricular and ventriculoarterial discordance, with anterior right aorta and posterior left pulmonary artery, infundibular septal defect with subarterial communication (asterisk), and anomalous origin of the right coronary artery in the left coronary sinus, coursing between the aorta and the pulmonary artery. AD: right atrium; AE: left atrium; Ao: aorta; CD: right coronary artery; Cx: circumflex artery; DA: anterior descending artery; P: pulmonary artery; VD: right ventricle; VE: left ventricle.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/21742049/0000003200000010/v1_201312121254/S2174204913001888/v1_201312121254/en/main.assets" "Apartado" => array:4 [ "identificador" => "9915" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images in cardiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21742049/0000003200000010/v1_201312121254/S2174204913001888/v1_201312121254/en/main.pdf?idApp=UINPBA00004E&text.app=https://revportcardiol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2174204913001888?idApp=UINPBA00004E" ]
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