Author + information
- Serdar Türkmen1,
- Mustafa Yolcu2,
- Alper Sertçelik1,
- Emrah İpek2,
- Barabaros Dokumacı1 and
- Talant Batyraliev1
The aim of our study is to determine in the incidence of single coronary arteries.
Single coronary artery (SCA) is a rarely seen coronary anomaly in which right coronary artery and left main coronary artery arise from single aortic sinus. It is detected usually during routine coronary angiography (CAG) or found incidentally in postmortem examination. It has an incidence of 0.014-0.066 % in general population. Most of these anomalies are clinically nonsignificant however some anomalies can be presented by angina, dyspnea, syncope, acute myocardial infarction and sudden cardiac death. Although SCA has a benign course most of the time and its clinical significance is unknown, in some autopsy studies it was shown to be related to sudden cardiac death.
SCA patients who detected among 215140 CAG performed between 1998 and 2013 years in SANKO Hospital were included in our study. Patients with SCA were selected retrospectively from coronary anomaly files created between these years and the incidence and clinical features of SCA patients were determined. The classification of CAG was made according to the two different classifications defined by Smith and Lipton and collegues. The Smith's system consists of three groups according to the course of the coronary arteries involved. Lipton and collegues classified the coronary anomalies as R or L according to the origination of abnormal coronary artery either from right or left coronary sinus. 39 (58%) patients had experienced exertional angina, and six (9%) patients had exertional dyspnea, three (4%) had syncope, four (6%) had palpitations, six (9%) had exertional angina and palpitations and six (9%) had exertional angina and syncope. Three of the patients were admitted with myocardial infarction. 26 (38%) patients had pathologic ST-T changes on ECG. Treadmill exercise test was performed in 56 patients and 34 (61%) of 56 patients had positive results.
A total number of 215140 patients who was undergone routine CAG were included in the study and SCA was detected in 67 (0.031%) patients. There were six (9%) type R-I, 23 (34%) type R-II, 10 (15%) type R-III, 16 (24%) type L-I and 12 (18%) type L-II patients according to the angiographic classification.
Coronary artery origin anomalies are rarely seen during routine cardiac catheterization and the incidence is 0.2-1.3% in angiographic series and 0.3% in autopsy series. In our data set including 215140 coronary angiographies of 15 years, there are 67 patients with SCA and the incidence is 0.31%. Coronary artery anomalies are the second most common cause of the sudden cardiac death in young athletes. Early diagnosis and treatment are crucial in order to lower the risk of sudden cardiac death in this population (Especially sportsmen) with higher sudden cardiac death risk.