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Anomalous origin of coronary arteries can be investigated in a broad spectrum that may vary between minor anomalies not affecting coronary perfusion and life threaten major anomalies. In various studies ratio of coronary anomaly was detected less than 1%. Because of common use of coronary angiography we detect coronary anomalies more frequently.
In this study 17.606 patients, performed coronary angiography between January 2011 and May 2013, were screened retrospectively. Patients with congenital heart disease and high take off of coronary arteries were excluded.
We detected coronary anomaly in 101 (0.53%) patients. 58 male (57.4%) and 43 female (42.6%), aged between 39-83 years (mean age 56.4±12.5). Eighty patients (79.2%) had anomalies of origin and distribution, 21 patients (20.7%) had coronary artery fistulae (Figure 1). The most common anomaly was separate origins of left anterior descending artery (LAD) and circumflex artery (Cx) in 28 patients (2.7%), with angiographic incidence of % 0.15. The second most common anomaly was anomalous origin of circumflex artery (originating from right coronary sinus/ RCA) in 19 patients (18.8%) with angiographic incidence of (0.1%) and the third was anomalous origin of right coronary artery (originating from left coronary sinus or LAD) in 18 patients (17.8%, 0.1%). Left main coronary artery or LAD originating right coronary sinus or RCA was seen in 7 patients (6.9%, 0.04%) (Figure 2). Right coronary artery agenesis was detected in 3 patients (2.9%, 0.013%), and coronary interconnection was found 2 patients (1.9%, 0.011%). Fifty-seven patients had coronary artery disease, eight patients presented with acute coronary syndrome. We determined eight patients with heart failure, three patients with mitral valve regurgitation, one patient with severe aortic regurgitation, one patient with ascending aorta aneurysm, three patients with muscular bridge and two patients with coronary ectasia. There was no additional cardiac pathology in twenty-six patients.
Angiographic recognition of these vessels is important because of their clinical significance in patients undergoing coronary angioplasty or cardiac surgery. In general although the incidence of coronary anomalies in our study was less than the results of previous studies, the pattern of coronary anomalies were similar to earlier reports.