Coronary artery anomalies in 126,595 patients undergoing coronary arteriography

Abstract

Coronary artery anomalies were found in 1,686 patients (1.3% incidence) undergoing coronary arteriography at the Cleveland Clinic Foundation from 1960 to 1988. Of the 1,686 patients, 1,461 (87%) had anomalies of origin and distribution, and 225 (13%) had coronary artery fistulae. Most coronary anomalies did not result in signs, symptoms, or complications, and usually were discovered as incidental findings at the time of catheterization. Eighty-one percent were "benign" anomalies: 1) separate origin of the left anerior descending and circumflex from the left sinus of Valsalva; 2) ectopic origin of the circumflex from the right sinus of Valsalva; 3) ectopic coronary origin from the posterior sinus of Valsalva; 4) anomalous coronary origin from the ascending aorta; 5) absent circumflex; 6) intercoronary communications; and 7) small coronary artery fistulae. Other anomalies may be associated with potentially serious sequelae such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. Potentially serious anomalies include: 1) ectopic coronary origin from the pulmonary artery; 2) ectopic coronary origin from the opposite aortic sinus; 3) single coronary artery; and 4) large coronary fistulae. Coronary artery anomalies require accurate recognition, and at times, surgical correction.

Anomalous right coronary artery originating from the distal left circumflex artery: A novel coronary artery anomaly viewed by computed tomography and invasive angiography

“…This was compatible with the Lipton L1 classification of single coronary artery anomalies (1). The absence of the RCA ostium originating as a continuation of the distal left circumflex artery is extremely rare, with an incidence of 0% to 0.035% (2). Such an anomaly is not expected to cause ischemia or any other complication.…”

Surgical treatment of a patient with heart disease and congenital coronary anomaly

“…Congenital anomalous origin of the coronary arteries may not be uncommon [2]. Angelini [3] reported that it might occur in 1-1.2 % of all coronary angiograms performed, with 0.15 % incidence of anomalous origination of the left coronary artery from the right sinus as that of the present case.…”

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

“…[10][11][12] Malignant anomalies may have serious implications such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. 13 Especially in the young, coronary anomalies are an important cause of sport-related sudden cardiac death. Coronary anomalies rank second as a cardiovascular cause of sudden death in the young behind hypertrophic cardiomyopathy.…”