Coronary arterial anomalies in a large group of patients undergoing coronary angiography in southeast Turkey

Abstract

Background: The prevalence of coronary artery anomalies (CAA) are reportedbetween 0.6–1.3% in the literature. CAA are usually asymptomatic incidental findings, but they may deteriorate coronary circulation, cause symptoms andlead to sudden cardiac death; especially in young athletes. Since interventionalprocedures are increasing rapidly for treatment of coronary artery disease (CAD) inthe modern era, comprehensive understanding of CAA is becoming progressively critical element in dealing with CAD.

Materials and methods: We reviewed the database of the Cardiac Catheterisation Laboratory of Sani Konukoglu University Hospital in Gaziantep, Turkey. All patientswho were subjected to coronary angiography from 1998 to 2006 were included.

Results: Among 53,655 coronary angiographies performed, CAA were foundin 653 patients (incidence of 1.21%); 590 (90.3%) patients had anomalies oforigin and distribution and 63 (11.7%) had coronary fistulae. Separate origins ofleft anterior descending (LAD) and left circumflex (LCX) coronary artery from theleft sinus of Valsalva was the most common anomaly (64.1%). Coronary arteriesbranching from anomalous aortic origin was the second most common anomaly(16.5%). Right coronary artery (RCA) originating from left sinus of Valsalva or leftmain coronary artery (LMCA) was observed in 55 (8.4%) patients, LCX arising fromRCA or right sinus of Valsalva (RSV) was seen in 52 (7.9%) patients and LMCA orLAD originating from RSV was seen in 14 (0.2%) patients. There were 16 (2.45%) patients with single coronary artery and 1 (0.15%) patient with LMCA originating from pulmonary artery.Conclusions: The incidence and the pattern of CAA in our patient population were similar with previous studies. Angiographic recognition of these vessels is importantbecause of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery.