ABSTRACT

Congenital coronary anomalies usually do not cause clinical problems; however, some of them might be presented with serious clinical pictures such as sudden death. We investigated the prevalence and characteristics of anomalous origin of coronary artery (AOCA) in patients who had coronary angiography.

The coronary angiography reports of 8,366 patients at our center between January 2013 and October 2018 were reviewed. Angiography images of patients who were reported to have AOCA were reevaluated.

Fifteen of 8,366 (0.18%) patients were found to have AOCA. The most commonly detected anomaly was anomalous origin of the circumflex artery (CX) originating from right coronary artery (RCA) or right sinus of Valsalva (RSV) in seven patients (prevalence 0.08% or 46.6% of all AOCA). Five patients showed a single coronary artery (prevalence 0.05% or 33.3% of all AOCA), which was arising from the RSV in three of them and from left sinus of Valsalva (LSV) in the rest of two. In two patients (0.02% or 13.3% of all AOCA), the left main coronary artery (LMCA) was originating from the RSV through separate ostium from the RCA. LMCA from the pulmonary artery was seen in one patient (0.01% or 6.6% of all AOCA). Four patients were found to have coronary artery disease (26.6% of all AOCA) and two of them presented with acute coronary syndrome.

The prevalence of AOCA was found at 0.18% in the present study. The most commonly seen anomaly was the origin of CX artery from RCA or RSV.