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(Circulation. 2001;104:3168.)
© 2001 American Heart Association, Inc.

Images in Cardiovascular Medicine

Post-Mortem Three-Dimensional Reconstruction of the Entire Coronary Arterial Circulation Using Electron-Beam Computed Tomography

Brian R. Rah, MD; Richard J. Katz, MD; Alan G. Wasserman, MD; Jonathan S. Reiner, MD

From the Division of Cardiology (B.R.R., R.J.K.), the Department of Medicine (A.G.W.), and the Cardiac Catheterization Laboratory (J.S.R.), George Washington University Medical Center, Washington, DC.

Correspondence to Brian R. Rah, Suite 4-414, Division of Cardiology, 2150 Pennsylvania Avenue, NW, Washington, DC 20037. E-mail cards111@aol.com

A 50-year-old man died suddenly while exercising on a treadmill at a local health club. He had no known previous cardiac history. During autopsy, a radio-opaque silicone compound was injected into the coronary arteries. The explanted heart was then imaged by electron-beam computed tomography (EBCT) using 3-mm slices. A complete 3D reconstruction was then obtained using commercially available software (Accuimage Diagnostics). Figure 1 shows the heart rotated into the equivalent of an angiographic left anterior oblique projection. This view reveals a completely occluded proximal right coronary artery. A significant narrowing involving a diagonal artery is also visible. Figure 2 corresponds to an angiographic right anterior oblique projection. The distal right coronary arterial circulation is supplied by collaterals from the left circumflex artery, and there is significant narrowing at the origin of the posterior descending coronary artery.

View larger version (102K): [in this window] [in a new window]   Figure 1. Angiographic equivalent of a left anterior oblique projection revealing a completely occluded proximal right coronary artery (solid arrow) and a significant narrowing involving a diagonal artery (dashed arrow).

View larger version (94K): [in this window] [in a new window]   Figure 2. Angiographic equivalent of a right anterior oblique projection. The distal right coronary arterial circulation is supplied by collaterals from the left circumflex artery (dashed arrow). A significant narrowing can also be seen at the origin of the posterior descending artery (solid arrow).

Footnotes

The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke’s Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.

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