Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-27T20:18:02.676Z Has data issue: false hasContentIssue false

Chapter 9 - The Coronary Arteries

Published online by Cambridge University Press:  19 August 2019

Michael T. Ashworth
Michael T. Ashworth
Affiliation:
Great Ormond Street Hospital for Children, London
Get access

Summary

A brief reprise of normal coronary artery structure is followed by a discussion of normal anatomical variants of the coronary arteries. The commoner abnormal variants, including origin of the left coronary artery from the pulmonary artery and intramural course of a coronary artery, are described and illustrated, followed by a discussion of coronary fistula and atresia. A section is devoted to the variations in coronary anatomy associated with the commoner forms of congenital heart disease. Coronary arteritis is discussed, chiefly in the context of Kawasaki disease, but polyarteritis and eosinophilic arteritis are also described. Fibromuscular dysplasia is treated in some detail and idiopathic arterial calcification rounds off the chapter.

Keywords

fistulaatresiaKawasakianomalous originfibromuscular dysplasiathrombosisembolismcongenital heart diseasevasculitis
Type
Chapter
Information
Pathology of Heart Disease in the Fetus, Infant and Child
Autopsy, Surgical and Molecular Pathology
 , pp. 203 - 220
Publisher: Cambridge University Press
Print publication year: 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Neufeld, HN, Schneeweiss, A (eds). Histological changes in the coronary arteries. In Neufeld & Schneeweiss: Coronary Artery Disease in Infants and Children. Philadelphia: Lea & Febiger; 1983, pp. 136–149.Google Scholar
Pesonen, E. Extrinsic and intrinsic factors relating to intimal thickening in children. Acta Paediatr Suppl 2004; 446: 43–47.Google Scholar
DeSa, DJ. Coronary artery ruptures in stillbirths. Pediatr Dev Pathol 2002; 5: 605.Google Scholar
Turkmen, S, Yolcu, M, Sertcelik, A et al. Single coronary artery incidence in 215,140 patients undergoing coronary angiography. Folia Morphol (Warsz) 2014; 73: 469–474.CrossRefGoogle ScholarPubMed
Ogden, JA, Goodyer, AV. Patterns of distribution of the single coronary artery. Yale J Biol Med 1970; 43: 11–21.Google Scholar
Yetman, AT, McCrindle, BW, MacDonald, C, Freedom, RM, Gow, R. Myocardial bridging in children with cardiomyopathy – a risk factor for sudden death. N Eng J Med 1998; 339: 1201–1209.CrossRefGoogle ScholarPubMed
Becker, AE. Variations of the main coronary arteries. In Becker, AE, Losekoot, TG, Marcelletti, C, Anderson, RH (eds) Paediatric Cardiology, Vol 3. Edinburgh: Churchill Livingstone; 1981, pp. 263–277.Google Scholar
Lujinović, A, Ovcina, F, Tursić, A. Third coronary artery. Bosn J Basic Med Sci 2008; 8: 226–229.Google Scholar
Rowlatt, UF. Coronary artery anatomy in complete transposition. JAMA 1962; 179: 269–278.Google Scholar
Adebo, D, Jacobson, Z, Harris, MA. Anomalous origin of the right coronary artery from the posterior, non-coronary sinus of Valsalva diagnosed by cardiac magnetic resonance imaging. Cardiol Young 2015; 25: 1006–1008.Google Scholar
Garg, A, Ogilvie, BC, McLeod, AA. Anomalous origin of the left coronary artery from the non-coronary sinus of Valsalva. Heart 2000; 84: 136.CrossRefGoogle ScholarPubMed
Lipsett, J, Cohle, SD, Berry, PJ, Russell, G, Byard, RW. Anomalous coronary arteries: a multicenter pediatric autopsy study. Pediatr Pathol 1994; 14: 287–300.CrossRefGoogle ScholarPubMed
Hobbs, RE, Millit, HD, Raghavan, PV, Moodie, DS, Sheldon, WC. Congenital coronary artery anomalies: clinical and therapeutic implications. Cardiovasc Clin 1981; 12: 43–58.Google ScholarPubMed
Arey, JB. Malformations of the coronary vessels. In Arey, JB (ed.) Cardiovascular Pathology in Infants and Children. Philadelphia: WB Saunders Company; 1984, pp. 204–217.Google Scholar
Takeuchi, S, Imamura, H, Katsumoto, K et al. New surgical method for repair of anomalous left coronary artery from pulmonary artery. J Thorac Cardiovasc Surg 1979; 78: 7–11.CrossRefGoogle ScholarPubMed
Kanoh, M, Inai, K, Shinohara, T, Tomimatsu, H, Nakanishi, T. Outcomes from anomalous origin of the left coronary artery from the pulmonary artery repair: long-term complications in relation to residual myocardial abnormalities. J Cardiol 2017; 70: 498–503.Google Scholar
Barth, CW 3rd, Roberts, WC. Left main coronary artery originating from the right sinus of Valsalva and coursing between the aorta and pulmonary trunk. J Am Coll Cardiol 1986; 7: 366–373.Google Scholar
Taylor, AJ, Byers, JP, Cheitlin, MD, Virmani, R. Anomalous right or left coronary artery from the contralateral coronary sinus: “high-risk” abnormalities in the initial coronary artery course and heterogeneous clinical outcomes. Am Heart J 1997; 133: 428–435.CrossRefGoogle ScholarPubMed
Rosenthal, RL, Carrothers, IA, Schussler, JM. Benign or malignant anomaly? Very high takeoff of the left main coronary artery above the left coronary sinus. Tex Heart Inst J 2012; 39: 538–541.Google Scholar
Loukas, M, Andall, RG, Khan, AZ et al. The clinical anatomy of high take-off coronary arteries. Clin Anat 2016; 29: 408–419.Google Scholar
Calder, AL, Co, EE, Sage, MD. Coronary arterial abnormalities in pulmonary atresia with intact ventricular septum. Am J Cardiol 1987; 59: 436–442.Google Scholar
Davis, JT, Allen, HD, Wheller, JJ et al. Coronary artery fistula in the pediatric age group: a 19-year institutional experience. Ann Thorac Surg 1994; 58: 760–763.Google Scholar
Holzer, R, Johnson, R, Ciotti, G, Pozzi, M, Kitchiner, D. Review of an institutional experience of coronary arterial fistulas in childhood set in context of review of the literature. Cardiol Young 2004; 14: 380–385.CrossRefGoogle ScholarPubMed
Krasemann, T, van Beynum, IM, Frohn-Mulder, IME, Dalinghaus, M. Endocarditis of a congenital coronary fistula in a child. Cardiol Young 2018; 28: 334–337.CrossRefGoogle ScholarPubMed
Ceresnak, S, Gray, RG, Altmann, K et al. Coronary artery fistulas: a review of the literature and presentation of two cases of coronary fistulas with drainage into the left atrium. Congenit Heart Dis 2007; 2: 208–213.Google Scholar
Haberman, JH, Howard, ML, Johnson, ES. Rupture of the coronary sinus with haemopericardium: a rare complication of coronary ateriovenous fistula. Circulation 1963; 28: 1143.CrossRefGoogle Scholar
Arey, JB. Malformations of the coronary arteries. In Arey, JB (ed.) Cardiovascular Pathology in Infants and Children. Philadelphia: WB Saunders Company; 1984, pp. 210–211.Google Scholar
Christmann, M, Hoop, R, Dave, H et al. Closure of coronary artery fistula in childhood: treatment techniques and long-term follow-up. Clin Res Cardiol 2017; 106: 211–218.Google Scholar
Liang, CD, Kuo, HC, Yang, KD, Wang, CL, Ko, SF. Coronary artery fistula associated with Kawasaki disease. Am Heart J 2009; 157: 584–588.CrossRefGoogle ScholarPubMed
Byard, RW, Smith, NM, Bourne, AJ. Association of right coronary artery hypoplasia with sudden death in an eleven-year-old child. J Forensic Sci 1991; 36: 1234–1239.Google Scholar
Baraona, F, Valente, AM, Porayette, P, Pluchinotta, FR, Sanders, SP. Coronary arteries in childhood heart disease: implications for management of young adults. J Clin Exp Cardiol 2012; (Suppl 8): pii: 006.CrossRefGoogle Scholar
Neufeld, HN, Schneeweiss, A (eds) Coronary arterial patterns in congenital heart disease. In Neufeld & Schneeweiss: Coronary Artery Disease in Infants and Children. Philadelphia: Lea & Febiger; 1983, pp. 79-118.Google Scholar
Li, J, Soukias, ND, Carvalho, JS, Ho, S. Coronary arterial anatomy in tetralogy of Fallot: morphological and clinical correlations. Heart 1998; 80: 174–183.Google Scholar
Need, LR, Powell, AJ, del Nido, P, Geva, T. Coronary echocardiography in tetralogy of Fallot: diagnostic accuracy, resource utilization and surgical implications over 13 years. J Am Coll Cardiol 2000; 36: 1371–1377.CrossRefGoogle ScholarPubMed
Meng, CC, Eckner, FA, Lev, M. Coronary artery distribution in tetralogy of Fallot. Arch Surg 1965; 90: 363–366.Google Scholar
Chiu, IS, Chu, SH, Wang, JK et al. Evolution of coronary artery pattern according to short-axis aortopulmonary rotation: a new categorization for complete transposition of the great arteries. J Am Coll Cardiol 1995; 26: 250–258.Google Scholar
Pasquali, SK, Hasselblad, V, Li, JS, Kong, DF, Sanders, SP. Coronary artery pattern and outcome of arterial switch operation for transposition of the great arteries: a meta-analysis. Circulation 2002; 106: 2575–2580.Google Scholar
Suzuki, A, Ho, SY, Anderson, RH, Deanfield, JE. Coronary arterial and sinusal anatomy in hearts with a common arterial trunk. Ann Thorac Surg 1989; 48: 792–797.Google Scholar
Gordillo, L, Faye-Petersen, O, de la Cruz, MV, Soto, B. Coronary arterial patterns in double-outlet right ventricle. Am J Cardiol 1993; 71: 1108–1110.CrossRefGoogle ScholarPubMed
Abuchaim, DC, Tanamati, C, Jatene, MB, Marcial, ML, Aiello, VD. Coronary dominance patterns in hypoplastic left heart syndrome. Rev Bras Cir Cardiovasc 2011; 26: 604–608.Google Scholar
Hansen, JH, Uebing, A, Scheewe, J, Kramer, HH, Fischer, G. Angiographic evaluation of the coronary artery anatomy in patients with hypoplastic left heart syndrome. Eur J Cardiothorac Surg 2012; 41: 561–568..CrossRefGoogle Scholar
Ismat, FA, Baldwin, HS, Karl, TR, Weinberg, PM. Coronary anatomy in congenitally corrected transposition of the great arteries. Int J Cardiol 2002; 86: 207–216.Google Scholar
Elliott, LP, Amplatz, K, Edwards, JE. Coronary arterial patterns in transposition complexes. Anatomic and angiocardiographic studies. Am J Cardiol 1966; 17: 362.CrossRefGoogle ScholarPubMed
McKay, R, Anderson, RH, Smith, A. The coronary arteries in hearts with discordant atrioventricular connections. J Thorac Cardiovasc Surg 1996; 111: 988–997.CrossRefGoogle ScholarPubMed
Newburger, JW, Fulton, DR. Kawasaki disease. Curr Opin Pediatr 2004; 16: 508–514.CrossRefGoogle ScholarPubMed
Daniels, LB, Gordon, JB, Burns, JC. Kawasaki disease: late cardiovascular sequelae. Curr Opin Cardiol 2012; 27: 572–577.CrossRefGoogle ScholarPubMed
Harada, M, Yokouchi, Y, Oharaseki, T et al. Histopathological characteristics of myocarditis in acute-phase Kawasaki disease. Histopathology 2012; 61: 1156–1167.CrossRefGoogle ScholarPubMed
Naoe, S, Takahashi, K, Masuda, H, Tanaka, N. Kawasaki disease with particular emphasis on arterial lesions. Acta Pathol Jpn 1991; 41: 785–797.Google ScholarPubMed
Newburger, JW, Fulton, DR. Kawasaki disease. Curr Opin Pediatr 2004; 16: 508–514.CrossRefGoogle ScholarPubMed
Fujiwara, H, Kawai, C, Hamashima, Y. Clinicopathologic study of the conduction system in 10 patients with Kawasaki Disease. Am Heart J 1978; 96: 744–750.Google Scholar
Shiraishi, I, Nishimura, K, Sakaguchi, H et al. Acute rupture of chordae tendineae of the mitral valve in infants: a nationwide survey in Japan exploring a new syndrome. Circulation 2014; 130: 1053–1061.Google Scholar
Orenstein, JM, Shulman, ST, Fox, LM, et al. Three linked vasculopathic processes characterize Kawasaki disease: a light and transmission electron microscopic study. PLoS One 2012; 7: e38998.Google Scholar
Takahashi, K, Oharaseki, T, Yokouchi, Y, Hiruta, N, Naoe, S. Kawasaki disease as a systemic vasculitis in childhood. Ann Vasc Dis 2010; 3: 173–181.Google Scholar
Hernández-Rodríguez, J, Alba, MA, Prieto-González, S, Cid, MC. Diagnosis and classification of polyarteritis nodosa. J Autoimmun 2014; 48–49: 84–89.CrossRefGoogle ScholarPubMed
Jennette, JC, Falk, RJ, Bacon, PA, et al. 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013; 65: 1e11.Google Scholar
Eleftheriou, D, Dillon, MJ, Tullus, K et al. Systemic polyarteritis nodosa in the young: a single-centre experience over thirty-two years. Arthritis Rheum 2013; 65: 2476–2485.Google Scholar
Erken, E, Erken, E. Cardiac disease in familial Mediterranean fever. Rheumatol Int 2018; 38: 51–58.Google Scholar
Mohammad, AJ, Jacobsson, LT, Mahr, AD, Sturfelt, G, Segelmark, M. Prevalence of Wegener’s granulomatosis, microscopic polyangiitis, polyarteritis nodosa and Churg Strauss syndrome within a defined population in southern Sweden. Rheumatology (Oxford) 2007; 46: 1329–1337.Google Scholar
Eleftheriou, D, Gale, H, Pilkington, C et al. Eosinophilic granulomatosis with polyangiitis in childhood: retrospective experience from a tertiary referral centre in the UK. Rheumatology (Oxford) 2016; 55: 1263–1272.CrossRefGoogle ScholarPubMed
Fina, A, Dubus, JC, Tran, A et al. Eosinophilic granulomatosis with polyangiitis in children: Data from the French RespiRare® cohort. Pediatr Pulmonol 2018; 53: 1640–1650.Google Scholar
Kajihara, H, Tachiyama, Y, Hirose, T et al. Eosinophilic coronary periarteritis (vasospastic angina and sudden death), a new type of coronary arteritis: report of seven autopsy cases and a review of the literature. Virchows Arch 2013; 462: 239–248.CrossRefGoogle Scholar
Khan, M, Schmidt, DH, Bajwa, T, Shalev, Y. Coronary air embolism: incidence, severity, and suggested approaches to treatment. Cathet Cardiovasc Diagn 1995; 36: 313–318.CrossRefGoogle ScholarPubMed
Hauck, AJ, Bambara, JF, Edwards, WD. Embolism of brain tissue to the lung in a neonate. Report of a case and review of the literature. Arch Pathol Lab Med 1990; 114: 217–218.Google Scholar
Takeuchi, M, Suzuki, T, Nakayama, M, Kenmochi, M, Kitajima, H. Neonatal myocardial infarction due to thrombotic occlusion. J Matern Fetal Neonatal Med 2006; 19: 121–123.Google Scholar
Rodríguez-Pintó, I, Moitinho, M, Santacreu, I et al.; CAPS Registry Project Group (European Forum on Antiphospholipid Antibodies). Catastrophic antiphospholipid syndrome (CAPS): Descriptive analysis of 500 patients from the International CAPS Registry. Autoimmun Rev 2016; 15: 1120–1124.Google Scholar
Deodhar, AP, Tometzki, AJ, Hudson, IN, Mankad, PS. Aortic valve tumor causing acute myocardial infarction in a child. Ann Thorac Surg 1997; 64: 1482–1484.Google Scholar
Xu, B, Fraser, RS, Renaud, C et al. Inflammatory myofibroblastic tumor of the aortic valves causing sudden cardiac death: a case report and review of the literature. Pediatr Dev Pathol 2014; 17: 231–239.CrossRefGoogle ScholarPubMed
Lüscher, TF, Lie, JT, Stanson, AW et al. Arterial fibromuscular dysplasia. Mayo Clin Proc 1987; 62: 931–952.Google Scholar
Arey, JB, Segal, R. Fibromuscular dysplasia of the intramyocardial coronary arteries. Pediatr Pathol 1987; 7: 97–103.Google Scholar
Zack, F, Kutter, G, Blaas, V, Rodewald, AK, Büttner, A. Fibromuscular dysplasia of cardiac conduction system arteries in traumatic and nonnatural sudden death victims aged 0 to 40 years: a histological analysis of 100 cases. Cardiovasc Pathol 2014; 23: 12–16.Google Scholar
Harrison, EG Jr, McCormack, LJ. Pathologic classification of renal arterial disease in renovascular hypertension. Mayo Clin Proc 1971; 46: 161–167.Google ScholarPubMed
Michelis, KC, Olin, JW, Kadian-Dodov, D, d’Escamard, V, Kovacic, JC. Coronary artery manifestations of fibromuscular dysplasia. J Am Coll Cardiol 2014; 64: 1033–1046.Google Scholar
Olin, JW, Froehlich, J, Gu, X et al. The United States Registry for Fibromuscular Dysplasia: results in the first 447 patients. Circulation 2012; 125: 3182–3190.Google Scholar
Imamura, M, Yokoyama, S, Kikuchi, K. Coronary fibromuscular dysplasia presenting as sudden infant death. Arch Pathol Lab Med 1997; 121: 159–161.Google Scholar
Lee, AH, Gray, PB, Gallagher, PJ. Sudden death and regional left ventricular fibrosis with fibromuscular dysplasia of small intramyocardial coronary vessels. Heart 2000; 83: 101–102.CrossRefGoogle Scholar
Persu, A, Touzé, E, Mousseaux, E et al. Diagnosis and management of fibromuscular dysplasia: an expert consensus. Eur J Clin Invest 2012; 42: 338–347.Google Scholar
Rolfes, DB, Towbin, R, Bove, KE. Vascular dysplasia in a child with tuberous sclerosis. Pediatr Pathol 1985; 3: 359–373.Google Scholar
Greene, JF, Fitzwater, JE, Burgess, J. Arterial lesions associated with neurofibromatosis. Am J Clin Pathol 1974; 62: 481–487.Google Scholar
Fortuin, NJ, Morrow, AG, Roberts, WC. Late vascular manifestations of the rubella syndrome. Am J Med 1971; 51: 134–140.Google Scholar
Maron, BJ, Wolfson, JK, Epstein, SE, Roberts, WC. Intramural (“small vessel”) coronary artery disease in hypertrophic cardiomyopathy. J Am Coll Cardiol 1986; 8: 545–557.Google Scholar
Safioleas, M, Kakisis, J, Manti, C. Coexistence of hypertrophic cardiomyopathy and fibromuscular dysplasia of the superior mesenteric artery. N Engl J Med 2001; 344: 1333–1334.Google Scholar
Slavin, RE. Segmental arterial mediolysis: course, sequelae, prognosis, and pathologic-radiologic correlation. Cardiovasc Pathol 2009; 18: 352–360.CrossRefGoogle ScholarPubMed
Morton, R. Idiopathic arterial calcification in infancy. Histopathology 1978; 2: 423–432.Google Scholar
Farquhar, J, Makhseed, N, Sargent, M, Taylor, G, Osiovich, H. Idiopathic infantile arterial calcification and persistent pulmonary hypertension. Am J Perinatol 2005; 22: 121–125.Google Scholar
Rutsch, F, Ruf, N, Vaingankar, S et al. Mutations in ENPP1 are associated with ‘idiopathic’ infantile arterial calcification. Nat Genet 2003; 34: 379–381.Google Scholar
Nitschke, Y, Rutsch, F. Inherited arterial calcification syndromes: etiologies and treatment concepts. Curr Osteoporos Rep 2017; 15: 255–270.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×