The Incidence and Pattern of Coronary Artery Anomalies in the North-West of Iran: A Coronary Arteriographic Study

Abstract

Background and ObjectivesCoronary artery anomalies are found in approximately 1% of patients undergoing diagnostic coronary angiography (CAG). Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery. There are fairly enough reports concerning the incidence of coronary anomalies in different geographic areas, but this is the first study among the Iranian population.Subjects and MethodsWe reviewed the database of the Catheterization Laboratory of Imam Reza and Shahid Madani Hospitals, Tabriz University of Medical Sciences, Iran. Our inquiry included all patients who referred for CAG from other hospitals, between February 2007 and April 2009. Patients with congenital heart diseases, high "take off" of coronary arteries and separate origin of the conus artery from the right coronary sinus (RCS) were excluded. In total, 6065 films were reviewed.ResultsSeventy nine (1.30%) patients were found to have coronary anomalies. Seventy five (1.24%) patients had anomalies of origin and distribution, while four (0.06%) had coronary artery fistulae. Most common anomaly was separate ostia of the left anterior descending artery and left circumflex artery, which was found in 42 patients (53.16%) with angiographic incidence of 0.69%. The next most common anomalies were anomalous circumflex artery from RCS/right coronary artery (RCA) {n=17 (21.51%)}, and anomalous RCA arising from left coronary sinus {n=6 (7.59%)}.ConclusionIn general, the incidence and pattern of coronary anomalies in our study was similar to earlier reports from different parts of the world.

Tools and techniques for angioplasty of anomalous origin of right coronary artery

“…Right radial approach using simple JR, or even better, LCB catheter and was suggested by Eyvaz Abbasov. 20 However our experience is that Amplatzer is the choice for any coronary arising higher than sinotubular junction. Both of our cases were intervened using Amplatzer guide, one with AR1 and the other using AL1 in par with reports by Yip et al, 21 Chaney et al, 22 The discussion of the AORCA is incomplete without a mention of the vascular access.…”

Intravascular Ultrasound guided Percutaneous Coronary Intervention for the Ostial Lesion of the Anomalous Left Circumflex Artery Originated from Left Coronary Cusp Directly

“…The separate origin of the LAD and LCX from the LCC is a rare congenital anomaly with a prevalence of 0.29%-0.69% [1][2][3][4]. PCI for an ostial lesion of an anomalous LCX originating from the LCC is challenging because it is difficult to correctly determine the position of the ostium.…”

“…A separate origin of the left anterior descending (LAD) and left circumflex artery (LCX) from the left coronary cusp (LCC) is a rare congenital anomaly and is found in 0.29%-0.69% of coronary angiography or computed tomography cases [1][2][3][4]. However, reports of percutaneous coronary intervention (PCI) for an anomalous LCX originating from the LCC are scarce.…”

Percutaneous coronary intervention in patients with anomalous origin of coronary artery presenting with acute coronary syndrome: A case series

“…2 There has been a tremendous surge in the utilization of CAG and angioplasty in recent years. 3 Cardiologists are encountering a wide variety of coronary anatomies, including aberrant coronaries and the detection of which is increasing day by day. 3 These aberrant arteries present a major challenge for both diagnosis and coronary intervention, if required.…”