It is unclear if anomalous coronary arteries are at higher risk for atherosclerosis. The link between anomalous coronary artery and early coronary artery disease has been suggested. The aim of this study is to determine whether the coronary artery anomaly predisposes to development of significant coronary disease. Using retrospective chart review, patients with documented anomalous coronary arteries recognized during coronary angiography between years 2000 to 2007 were analyzed. Prevalence of significant atherosclerotic coronary artery disease (defined as more than 50% luminal narrowing) was compared between normal and anomalous coronaries. A total of 147 patients with anomalous coronary arteries were found. Right coronary artery was the most common anomalous artery 128 of 148 (86.5%) in our dataset. There was no difference in the occurrence of atherosclerosis between anomalous and nonanomalous coronaries. Significant atherosclerosis was present in 59 of the 148 anomalous coronary arteries (37.8%), and 112 of the 293 nonanomalous coronary arteries (38.2%, p?=?0.9). On the basis of our study, there is no evidence that anomalous coronary arteries predispose to significant coronary artery disease in comparison to normal coronary arteries.

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An 86-year-old female patient with a history of bypass surgery was admitted for recurrent dyspnea and chest pain on exertion. She underwent coronary angiography showing high-grade saphenous vein graft stenosis supplying the right coronary. During an attempt to perform percutaneous intervention, saphenous vein graft to the right coronary artery was injured by the guide catheter resulting in dissection with thrombus formation but with normal distal blood flow. The procedure was abandoned since she had normal distal flow and also due to a fear of causing extension of the dissection with further manipulation. The patient was hemodynamically stable and free of chest pain after 30 minutes of observation. The patient was later discharged home on medical treatment. After 1 month, a repeat angiography showed patent saphenous vein graft to the right coronary artery with healed dissection. This is the first case report of spontaneous recovery of iatrogenic saphenous vein graft dissection. This case is followed by the review of literature.