Can We Better Understand the Known Variations in Coronary Arterial Anatomy?

Chiu, Ing‐Sh; Anderson, Robert H.

doi:10.1016/j.athoracsur.2012.05.133

Cited by 29 publications

(26 citation statements)

References 53 publications

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“…It is now understood that coronary arteries develop within the epicardial atrioventricular and interventricular grooves and that their proximal parts grow into the aortic valve sinuses [1] . The left coronary artery arises from the left posterior quadrant of the proximal bulbus cordis, while the right coronary artery arises from the right side.…”

Section: Coronary Arteries Embryologymentioning

confidence: 99%

“…According to this approach, a CAA can be defined as a coronary pattern or feature that is encountered in less than 1% of the general population. In summary, we can divide the coronary feature in two groups: (1) normal coronary anatomy, defined as any morphological characteristics seen in > 1% of unselected sample. This group also includes normal anatomical variants, defined as alternative and relatively unusual morphological feature observed in > 1% of the population; and (2) anomalous coronary anatomy, defined as morphological features found in < 1% of the population [8][9][10] .…”

Section: Definitionsmentioning

confidence: 99%

“…Based on the functional relevance of each abnormality, CAAs can be classified as: (1) anomalies with obligatory ischaemia, as seen in anomalous origin of the LMCA from the pulmonary artery, or in coronary ostial atresia or severe stenosis; (2) anomalies without ischaemia; this group comprises the majority of CAAs and are not associated with clinical events; and (3) anomalies with exceptional ischemia: This is a group of CAAs that only occasionally cause critically severe clinical events, but are otherwise compatible with leading a normal life, including athletic training.…”

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

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Coronary artery anomalies overview: The normal and the abnormal

Villa¹,

Sammut²,

Nair³

et al. 2016

WJR

293

281

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The aim of this review is to give a comprehensive and concise overview of coronary embryology and normal coronary anatomy, describe common variants of normal and summarize typical patterns of anomalous coronary artery anatomy. Extensive iconography supports the text, with particular attention to images obtained in vivo using non-invasive imaging. We have divided this article into three groups, according to their frequency in the general population: Normal, normal variant and anomaly. Although congenital coronary artery anomalies are relatively uncommon, they are the second most common cause of sudden cardiac death among young athletes and therefore warrant detailed review. Based on the functional relevance of each abnormality, coronary artery anomalies can be classified as anomalies with obligatory ischemia, without ischemia or with exceptional ischemia. The clinical symptoms may include chest pain, dyspnea, palpitations, syncope, cardiomyopathy, arrhythmia, myocardial infarction and sudden cardiac death. Moreover, it is important to also identify variants and anomalies without clinical relevance in their own right as complications during surgery or angioplasty can occur.

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Section: Coronary Arteries Embryologymentioning

confidence: 99%

Section: Definitionsmentioning

confidence: 99%

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

See 1 more Smart Citation

Coronary artery anomalies overview: The normal and the abnormal

Villa¹,

Sammut²,

Nair³

et al. 2016

WJR

293

281

View full text Add to dashboard Cite

show abstract

“…On the other hand, "natural risk" associated with CCAA has usually been of main concern in numerous classifications during the last three decades. As a result, the clinical attention to isolated (primary) CCAA with low or no natural risk has slacked within cardiac surgical community [4,5,8,9,10].…”

Section: Discussionmentioning

confidence: 99%

Anomalous aortic origin of right and circumflex coronary arteries - procedural risks during combined aortic valve replacement and coronary artery bypass grafting

et al. 2018

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Introduction Anomalous aortic origin of the right and the circumflex coronary arteries presents extremely rare and potentially dangerous combination in patients scheduled for combined coronary bypass grafting and aortic valve replacement surgery. We report this illustrative case to emphasize the importance of meticulous diagnostic setup enabling the surgeon to anticipate and avoid numerous possible pitfalls. Case outline A 74-year-old woman, with anterior-wall myocardial infarction and aortic valve stenosis, underwent successful combined coronary artery bypass grafting and aortic valve replacement. Preoperative coronary angiography revealed unusually high takeoff of the right main coronary trunk and anomalous origin and course of the circumflex coronary artery. Anatomy of both anomalous coronary arteries in the light of underlying surgical pathology necessitated a meticulous preparation and caution during successive phases of surgical treatment. Conclusion Estimating potential procedural risk should be standard practice for each patient with known congenital coronary artery anomalies, regardless of the natural risk imposed by a particular anomaly. Preoperative evaluation of coronary circulation, with high surgical awareness and knowledge of different congenital coronary artery anomalies, should be a standard approach in cardiac surgical practice. This would add a predictive value for an actual procedural risk in cases of previously unrecognized anomalies.

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“…The left coronary and right coronary sinuses are named as such because they are the usual origins of the left and right coronary arteries respectively, although variations exist in less than 1% of the patients in angiography studies (Topaz et al, ; Garg et al, ; Tuncer et al, ; Chiu and Anderson, ). Both arteries take off at 1–2 cm above the basal valvar attachment (Ho, ).…”

Section: Both Coronary Arteries and Veins Are Closely Related To The mentioning

confidence: 99%

The anatomic basis for ventricular arrhythmia in the normal heart: What the student of anatomy needs to know

et al. 2014

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The traditional route for teaching cardiac anatomy involves didactic instruction, cadaver dissections, and familiarization with the main structure and relationships of the cardiac chambers, valves, and vasculature. In contemporary cardiac electrophysiology, however, a very different view of anatomy is required including details rarely appreciated with a general overview. In this review, we discuss the critical advances in cardiac electrophysiology that were possible only because of understanding detailed anatomic relationships. While we briefly discuss the clinical relevance, we explain in depth the necessary structural information for the student of clinical anatomy. Interspersed through the text are boxes that highlight and summarize the critical pieces of knowledge to be borne in mind while studying the fascinating structural anatomy of the human heart.

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Can We Better Understand the Known Variations in Coronary Arterial Anatomy?

Cited by 29 publications

References 53 publications

Coronary artery anomalies overview: The normal and the abnormal

Coronary artery anomalies overview: The normal and the abnormal

Anomalous aortic origin of right and circumflex coronary arteries - procedural risks during combined aortic valve replacement and coronary artery bypass grafting

The anatomic basis for ventricular arrhythmia in the normal heart: What the student of anatomy needs to know

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