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Change of Coronary Artery Indices according to Coronary Dominance Pattern in Early Childhood.

Purpose: Coronary arterial lesion assessment in children can be difficult depending on the coronary dominance pattern. Although it is easier to determine coronary dominance with echocardiography in children than in adults, difficulty still exists. This study aimed to examine coronary dominance pattern according to objective Coronary artery (CA) indices.

Methods: CA diameter, aortic valve annulus, and abdominal aorta were measured with cross-sectional echocardiography in 69 children without any cardiovascular disease at Chungnam National University Hospital. To evaluate the coronary dominance pattern, echocardiography was primarily used and additionally, coronary computed tomographic angiography or Coronary angiography (CAG). Coronary dominance was determined according to the coronary artery that gives rise to the posterior descending artery.

Results: The mean age was 4.02±2.78 years, and the mean body surface area (BSA) was 0.70±0.22 m2. Right dominance was present in 78% and left in 22% of the subjects. In those with left dominance, the CA to aortic valve annulus diameter ratio was 0.125±0.021 in right coronary artery (RCA) and 0.255±0.032 in left coronary artery (LCA). In those with right dominance, the corresponding ratio was 0.168±0.028 in RCA and 0.216±0.030 in LCA(P<0.05). Significant differences were also found in the diametric ratios of CA to BSA and abdominal aorta (P<0.05).

Conclusion: coronary artery indices showed significant difference according to coronary dominance pattern in early childhood. It is possible to indirectly determine the coronary dominance pattern by coronary artery indices in children using echocardiography. The accuracy of CAL diagnosis can be improved by taking coronary dominance into account.

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