Recommendations for Multimodality Assessment of Congenital Coronary Anomalies: A Guide from the American Society of Echocardiography Developed in Collaboration with the Society for Cardiovascular Angiography and Interventions, Japanese Society of Echocardiography, and Society for Cardiovascular Magnetic Resonance

Congenital coronary artery anomalies, both in isolation and associated with other forms of congenital heart disease, have been recognized as important lesions with significant potential morbidity and mortality, including sudden cardiac death in children and adolescents. Multimodality imaging techniques have demonstrated increasing utility in the characterization of most congenital coronary anomalies, both in children and adults, and may reduce the need for diagnostic catheterization in many cases. This document provides multimodality guidelines for optimization of imaging for congenital coronary anomalies, with a review of the benefits and limitations of the different imaging techniques (echocardiography, cardiac computed tomography, cardiac magnetic resonance imaging, nuclear myocardial perfusion imaging and angiography). Strategies for imaging congenital coronary anomalies when the coronary anomaly is in isolation (anomalous aortic origin of a coronary artery, anomalous left coronary from the pulmonary artery, and coronary artery fistulas) as well as coronary anomalies associated with other congenital heart disease (supravalvular aortic stenosis, transposition of the great arteries, tetralogy of Fallot, truncus arteriosus, pulmonary atresia with intact septum, and hypoplastic left heart syndrome) are described.