Woven Coronary Artery Anomaly: An Incidental Finding and Literature Review

Table 2

Outline of the clinical details of the woven anomaly case reports found in the literature.

#	Presenting symptom	ECG	Echocardiography	Ischemia assessment	OCT	IVUS	Woven anomaly vessel	Diseased artery	Treatment	Outcome or F/U
1	Shortness of breath				Not done	Not done	Proximal RCA
2	Incidental			Exercise ECG: diffuse ST depression in anterolateral and inferior leads+thallium scan: inferoposterior defect	Not done	Not done	Middistal RCA	PDA
3	ACS			Positive thallium scan	Not done	Not done	LAD, LCX, and OM
	ACS				Not done	Not done	Proximal LCX	LAD, LCX	PTCA for mid LAD (percutaneous transluminal coronary angioplasty)
	ACS				Not done	Not done	Distal LAD	LAD
4	Chest pain				Not done	Not done	Middistal RCA	RCA
5	Chest pain	Normal	Moderate aortic insufficiency	Stress ECG: ST depression in inferior leads	Not done	Not done	Mid LCX	RCA	PCI+aortic valve replacement	Unremarkable 5-year follow-up
6	Kawasaki disease	Prolonged PR interval			Not done	Not done	Proximal RCA		Aspirin and IV immunoglobulin for Kawasaki disease	Unremarkable 4-year follow-up
7	Chest pain		Normal LV wall motion, left ventricular EF: 60%	Stress ECG: ST depression in V1-V4+myocardial perfusion imaging: reversible ischemia in the anterior wall	Not done	Not done	Proximal RCA	LAD	PCI	Unremarkable 3-year follow-up on the woven artery. However, distal LAD developed 70% stenosis which required medical treatment
8	Atypical left arm pain	Old inferior infarction and T-wave inversion in V5-v6	Normal systolic function, inferior wall akinesis, and mild mitral regurge	Stress and rest Tc 99 m sestamibi scan: stress-induced myocardial ischemia in inferior and lateral leads	Not done	Not done	RCA	RCA	Medical treatment	Unremarkable 2-year follow-up
9	ACS	Normal	LV hypertrophy, mild diastolic dysfunction, and hypokinesia of the posterolateral wall with an ejection fraction of 55%		Not done	Not done	LAD, LCX, and OM2	LAD, LCX, and OM2	PCI	Unremarkable 1-year follow-up
10	ACS	ST depression in lead II, III, aVF, and V4-V6	LV hypokinesis, mild mitral insufficiency		Not done	Not done	Distal RCA	LM, LAD, LCX, and RCA	Medical treatment+CABG operation	Unremarkable postop
11	Chest pain	Normal	Normal wall motion, left ventricular EF: 65%	Stress ECG: ST-segment depression+thallium-201 myocardial perfusion imaging: no ischemia	Not done	Not done	LAD, LCX, RCA		Medical treatment+smoking cessation
12	Chest pain	Sinus tachycardia, RBBB with marked ST-segment depression in precordial leads	Global hypokinesis, left ventricular EF: 30%		Not done	Not done	Proximal-distal RCA, proximal-mid LAD
13	Incidental	Abnormal Q waves in leads V1–V6	Severe hypokinesia in the apical and anterior walls of the left ventricle, left ventricular EF: 45%	Infarction in the anterior and apical walls of the left ventricle, without any myocardial ischemia	Done	Not done	Proximal-mid LAD, proximal DI branch	LAD	Medical treatment
14	ACS	Normal	Normal LV wall motion, left ventricular EF: 60%	Dobutamine stress echo: reversible ischemia in inferior wall	Not done	Not done	RCA	RCA due to stenosis before the woven segment	Medical treatment
15	Chest pain			SPECT: stress-induced ischemia in the inferior wall of LV	Done	Not done	Mid-RCA	Distal RCA stenosis, CTO of PDA	CABG
16	ACS				Not done	Not done	Proximal LAD, RCA, OM, and 1st diagonal	LAD	CABG	Unremarkable postop
17	Chest pain	Negative T waves in leads DII, DIII, and aVF	Normal LV wall motion, left ventricular EF: 65%	Myocardial perfusion imaging: no ischemia in the anterior wall	Not done	Not done	Distal LAD	LCX	Medical treatment	Unremarkable 1-year follow-up
18	Chest pain	Q waves and extrasystoles on D3 and aVF	Akinesia at inferior and posterior walls, left ventricular EF: 44%	Inferior wall ischemia was detected which approximately refers to 14% of the left ventricle	Not done	Not done	Mid-RCA	RCA	PCI
19	Chest pain	Incomplete LBBB	Normal systolic function, LV hypertrophy	Myocardial perfusion imaging: reversible ischemia in inferior and posterior walls	Not done	Not done	RCA		Medical treatment
20	Palpitations	Atrial flutter	Akinesia in the anterior and apical walls, severe hypokinesia in the other LV walls, and left ventricular EF: 22.5%	Stress-induced ischemia and a fixed low uptake in the anterior and apical walls	Not done	Done	Proximal-mid LAD		Cavotricuspid isthmus (CTI) ablation
21	Sudden cardiac death	Asystole which could not be converted back to sinus rhythm					Mid RCA	RCA		Death
22	Exertional shortness of breath				Not done	Not done	LCX	LCX	CABG+mitral valve repair	Unremarkable 4-week follow-up
23	Incidental [symptoms of acute ischemic stroke of embolic origin]	Q waves in inferior leads	Akinesia in inferior and inferobasal walls, mild mitral regurgitation, and left ventricular EF: 40%	Myocardial perfusion scintigraphy: inferior wall fixed hypoperfusion, infarct, and mild peri-infarct ischemia	Not done	Not done	RCA	RCA	Medical treatment	Unremarkable 2-year follow-up
24	Congestive heart failure	Normal	Normal left ventricular EF		Done	Not done	LAD		Medical treatment
	ACS		Regional inferior wall motion abnormality		Done	Not done	Distal RCA	RCA	PCI
	Chest pain	Inverted T waves on precordial and inferior leads	NA		Done	Not done	Proximal RCA	LAD	PCI	Unremarkable 1-year follow-up
25	ACS	ST-segment elevation in the inferior leads	Normal LV wall motion, left ventricular EF: 59%		Not done	Not done	Proximal-mid RCA	RCA	CABG
26	Chest pain	Atrial fibrillation in rhythm and Q wave in the inferior leads	Left ventricular EF: 40%		Not done	Done	RCA	RCA	PCI	Unremarkable 9-month follow-up. LVEF improved by 4% (44%)
27	Chest pain				Done	Done	RCA
28	Exertional shortness of breath		Rheumatic heart disease		Not done	Not done	Middistal RCA	LAD	CABG+mitral valve replacement
29	ACS	ST-segment elevation in the anterior V1-V5 leads	Akinesia at anterior walls, left ventricular EF: 54%		Done	Not done	LAD	LAD	PCI	Unremarkable 4-year follow-up
30	ACS			Ischemia in the inferior wall	Done	Not done	RCA	RCA	PCI
31	Chest pain				Not done	Not done	LAD, LCX, RCA	LAD	PCI	Unremarkable 3-year follow-up
32	ACS [referred]				Done	Not done	RCA	RCA	PCI
33	Incidental	Normal	Normal LV systolic function, left ventricular EF: >55%, moderately severe pulmonary hypertension, and mild dilatation of the right atrium	Not performed	Done	Done	RCA	RCA	PCI	Unremarkable 3-month follow-up