Clinical and CT Features, Clinical Management, and Decision on Sport Eligibility of Professional Athletes with Congenital Coronary Anomalies: A Case Series Study

Figures

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  Figure 1. Anomaly of the right coronary artery from the left Valsalva sinus. In panel (A), the origin of the coronary artery is visible, showing an oval-shaped ostium, as indicated by the yellow arrow; panels (B,C) display the course of the vessel after its emergence from the left sinus; in panel (D), high take-off is observed, as indicated by the yellow arrow.

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  Figure 2. In panels (A,B), the CCTA images show the malignant features of the myocardial bridge, with a length > 25 mm and a depth > 2 mm. In panel (C), the anterolateral repolarization abnormalities present at baseline, before correction, are displayed. In panel (D), the coronary angiographic study shows the presence of the bridge at the mid-distal LAD, along with the functional assessment, with an RFR value of 0.82. An RFR of 0.82 indicates a hemodynamically significant and severe coronary stenosis.

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  Figure 3. In panel (A), the cardiac MRI in the coronary study sequence shows the right coronary artery, indicated by the yellow arrow, originating from the left Valsalva sinus. In panels (B–D), similar images from the CCTA are shown, with the right coronary artery originating from the left sinus.

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  Figure 4. CCTA images of the patient from case 4 with coronary fistula; the two yellow arrows indicate the two points where the fistulous tracts begin, which then give rise to the coronary malformation.

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  Figure 5. CCTA of the patient from case 5. In panel (A), the common origin of the right and left coronary arteries from the left Valsalva sinus is shown; in panels (B,C), the yellow arrows indicate the presence of the intramyocardial bridge on the LAD.