Epidemiology of coronary abnormalities of discharge and branching and their clinical significance

Purpose.Until the mid-20th century they could be discovered only during autopsy, it means after death. With the introduction of coronary angiography it become possible to find them in a living person. Later on, new modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) enhanced futher our abilities. It is very important to discover coronary anomalies in a living person, because some of them could lead to sudden cardiac death (SCD). In fact, coronary artery anomalies are the second main cause of the SCD in young athletes. Another importance is driven by the fact, that some of them could lead to lifethreatening complications during cardiac surgery when unknown before the operation.Methods.We prospectively reviewed all coronary angiography films from 2011 to 2016 in our center. Coronary anomalies were reviewed and classified by two independent experienced operators. Patients with congenital heart disease and coronary fistulas were excluded.Results.Out of 5055 patients 148 (2.9%) had coronary artery anomalies of origin and distribution. Those were 120 men (81.1%) and 28 women (18.9%) with an age range between 29 to 88 years. The three most common anomalies were myocardial bridge (48.7%), separate origin of the conus branch (13.5%) and separate origin of the LAD and LCX (8.1%).Conclusion.In our study we found more or less the same types and incidence rates of coronary artery anomalies as in the world literature. We had apparently higher rates of myocardial bridges, compared to average number on angiography studies, but very close to authopsy study rates.

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Incidence and clinical relevance of primary congenital anomalies of the coronary arteries in children and adults

Cardiology in the Young ◽

10.1017/s1047951112000959 ◽

2012 ◽

Vol 23 (3) ◽

pp. 381-386 ◽

Cited By ~ 16

Author(s):

Giulia Tuo ◽

Maurizio Marasini ◽

Claudio Brunelli ◽

Lucio Zannini ◽

Manrico Balbi

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Pulmonary Artery ◽

Left Coronary Artery ◽

Paediatric Population ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Anomalous Left Coronary Artery ◽

Left Circumflex Artery ◽

Anomalous Left Coronary

AbstractObjectivesTo describe our experience in the management of coronary artery anomalies both in an adult and in a paediatric population and to compare the two groups for finding out differences in terms of angiographic incidence and treatment.Patients and methodsDatabases at the Department of Cardiology of San Martino Adult's Hospital and of Gaslini Children's Hospital were searched for all patients with a diagnosis of coronary artery anomaly who underwent coronary angiography between 1994 and 2006.ResultsCoronary anomalies were diagnosed in 76 (1%) adult patients. Anomalous left circumflex artery was the commonest coronary anomaly (25%). Anomalous left coronary artery from pulmonary artery and myocardial bridges were the only anomalies responsible for angina-like symptoms. No patients except the one with anomalous left coronary artery from pulmonary artery needed surgical intervention. In the paediatric population, we found 28 (0.9%) patients with coronary anomalies. Anomalous left coronary artery from pulmonary artery was the most common anomaly (48%) and always required emergency surgical treatment; in addition there were two patients with stenosis of the left main coronary artery.ConclusionCoronary artery anomalies may be associated with very acute, even life-threatening symptoms in children, whereas they are usually clinically silent and detected by accident on coronary angiography in adults. Recognition of coronary artery anomalies enables early treatment or close follow-up in children, whereas it could be useful in case of cardiac surgery in adults.

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Frequency of Coronary Artery Anomalies in patients undergoing Coronary Angiography.

The Professional Medical Journal ◽

10.29309/tpmj/2020.27.02.4213 ◽

2020 ◽

Vol 27 (02) ◽

pp. 377-380

Author(s):

Imran Javaid ◽

Muhammad Akram ◽

Shahbaz Amjad ◽

Rehan Riaz ◽

Ali Ehsan ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Incidental Finding ◽

Cross Sectional Study ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Cross Sectional ◽

The Mean ◽

And Function ◽

Study Setting

Coronary artery anomalies are abnormalities in coronary arteries by birth (congenital) and involve their anatomy, course and function. They usually occur in association with other congenital cardiac defects. Coronary artery anomalies are usually clinically silent as they do not cause symptoms and are found incidentally but relatively few become evident by causing symptoms. Objectives: Determine the frequency of coronary artery anomalies in patients undergoing coronary angiography. Study Design: Cross sectional study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Period: From July to December 2017. Material & Methods: Demographic information from all the patients was recorded and all of these individuals were undergone coronary angiography. All the collected data was analyzed by SPSS. Results: The mean age of the patients was 43.74 ± 15.35 years, male and female patients were equal in number. In this study coronary anomalies were present in 28(4.06%) patients. Conclusion: Coronary artery anomalies are found quite frequently but usually are incidental finding.

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Paediatric-onset coronary artery anomalies in pregnancy: a single-centre experience and systematic literature review

Cardiology in the Young ◽

10.1017/s1047951117000658 ◽

2017 ◽

Vol 27 (8) ◽

pp. 1529-1537 ◽

Cited By ~ 3

Author(s):

Michelle Keir ◽

Catriona Bhagra ◽

Debra Vatenmakher ◽

Francisca Arancibia-Galilea ◽

Katrijn Jansen ◽

...

Keyword(s):

Myocardial Infarction ◽

Cardiac Arrest ◽

Coronary Artery ◽

Cardiovascular Events ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Major Cardiovascular Events ◽

Coronary Aneurysms ◽

Increased Risk ◽

In Pregnancy

AbstractObjectivesIndividuals with childhood-onset coronary artery anomalies are at increased risk of lifelong complications. Although pregnancy is thought to confer additional risk, a few data are available regarding outcomes in this group of women. We sought to define outcomes of pregnancy in this unique population.MethodsWe performed a retrospective survey of women with paediatric-onset coronary anomalies and pregnancy in our institution, combined with a systematic review of published cases. We defined paediatric-onset coronary artery anomalies as congenital coronary anomalies and inflammatory arteriopathies of childhood that cause coronary aneurysms. Major cardiovascular events were defined as pulmonary oedema, sustained arrhythmia requiring treatment, stroke, myocardial infarction, cardiac arrest, or death.ResultsA total of 25 surveys were mailed, and 20 were returned (80% response rate). We included 46 articles from the literature, which described cardiovascular outcomes in 82 women (138 pregnancies). These data were amalgamated for a total of 102 women and 194 pregnancies; 59% of women were known to have paediatric-onset coronary artery anomalies before pregnancy. In 23%, the anomaly was unmasked during or shortly after pregnancy. The remainder, 18%, was diagnosed later in life. Major cardiovascular events occurred in 14 women (14%) and included heart failure (n=5, 5%), myocardial infarction (n=7, 7%), maternal death (n=2, 2%), cardiac arrest secondary to ventricular fibrillation (n=1, 1%), and stroke (n=1, 1%). The majority of maternal events (13/14, 93%) occurred in women with no previous diagnosis of coronary disease.ConclusionsWomen with paediatric-onset coronary artery anomalies have a 14% risk of adverse cardiovascular events in pregnancy, indicating the need for careful assessment and close follow-up. Prospective, multicentre studies are required to better define risk and predictors of complications during pregnancy.

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Coronary artery anomalies in adults: Imaging at dual source CT coronary angiography

Journal of Medical Imaging and Radiation Oncology ◽

10.1111/j.1754-9485.2012.02428.x ◽

2012 ◽

Vol 57 (2) ◽

pp. 184-190 ◽

Cited By ~ 4

Author(s):

Fotios Laspas ◽

Arkadios Roussakis ◽

Christos Mourmouris ◽

Nikolaos Kritikos ◽

Roxani Efthimiadou ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Ct Coronary Angiography ◽

Dual Source Ct ◽

Coronary Artery Anomalies ◽

Dual Source

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Prevalence and characteristics of coronary artery anomalies using invasive coronary angiography in 6,237 consecutive patients in a single center in Turkey

Journal of Clinical & Experimental Cardiology ◽

10.4172/2155-9880-c1-081 ◽

2017 ◽

Vol 08 (10) ◽

Author(s):

Kenan Erdem ◽

Yilmaz Ozbay

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Invasive Coronary Angiography ◽

Single Center ◽

Coronary Artery Anomalies

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Coronary artery anomalies in North Indian population: a conventional coronary angiographic study

National Journal of Clinical Anatomy ◽

10.1055/s-0039-1700760 ◽

2017 ◽

Vol 06 (04) ◽

pp. 250-257

Author(s):

Yogesh Diwan ◽

Deepa Diwan ◽

Randhir S. Chauhan ◽

Prakash C. Negi

Keyword(s):

Coronary Artery Disease ◽

Coronary Artery ◽

Indian Population ◽

Tertiary Care ◽

Clinical Aspects ◽

Single Coronary Artery ◽

North Indian Population ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Artery Disease

Abstract Background: Anomalies of origin and course of one or both coronary arteries, with or without symptoms, are of special interest for anatomists, interventional cardiologists, and cardiac surgeons. Aims: To estimate the prevalence of coronary anomalies and their clinical aspects in North Indian population. Material and Methods: Study was done on patients undergoing coronary angiography for suspected coronary artery disease or for coronary intervention at a tertiary care centre in North India. Results: A total of 1130 patients [803 males, 327 females and mean age 57.37°10.60 years] were reviewed for coronary artery anomalies. Overall incidence of Coronary artery anomalies was 13 [1.15%] and was 1% in men and 1.53% in women. 38.46% of these patients were found to have ectopic origin of left circumflex [LCx] and in 23.08% of cases, ectopic origin of right coronary artery [RCA] was noted. Separate orifice for left anterior descending [LAD] and LCx in left coronary sinus [LCS] was observed in 0.27% cases, coronary artery fistula [CAF] in 0.09% cases and single coronary artery from LCS was found in 0.09% cases. Conclusions: The most common coronary anomalies were origin of LCx from RCA and presence of separate orifice for LAD and LCx in LCS. Dominance, gender and coronary artery disease [CAD] have no association with coronary anomalies.

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Screening for proximal coronary artery anomalies with 3-dimensional MR coronary angiography

The International Journal of Cardiovascular Imaging ◽

10.1007/s10554-010-9617-0 ◽

2010 ◽

Vol 26 (6) ◽

pp. 701-710 ◽

Cited By ~ 30

Author(s):

Niek H. Prakken ◽

Maarten J. Cramer ◽

Marlon A. Olimulder ◽

Pierfrancesco Agostoni ◽

Willem P. Mali ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Angiography ◽

Coronary Artery Anomalies ◽

3 Dimensional ◽

Mr Coronary Angiography ◽

Proximal Coronary Artery

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Management and Anesthetic Considerations for Patients With Anomalous Aortic Origin of a Coronary Artery

Seminars in Cardiothoracic and Vascular Anesthesia ◽

10.1177/1089253218793888 ◽

2018 ◽

Vol 22 (4) ◽

pp. 383-394 ◽

Cited By ~ 1

Author(s):

Benjamin Kloesel ◽

Martina Richtsfeld ◽

Mojca Konia ◽

John L. Bass

Keyword(s):

Coronary Artery ◽

Risk Stratification ◽

Coronary Arteries ◽

Anesthetic Management ◽

Heterogeneous Group ◽

Coronary Anomalies ◽

Disease Group ◽

Coronary Artery Anomalies ◽

Fatal Disease ◽

Anesthetic Considerations

The term “coronary artery anomalies” encompasses a large and heterogeneous group of disorders that may affect origin, intrinsic anatomy, course, location, and termination of the coronary arteries. With these different anatomies, presentation, symptoms, and outcomes are heterogeneous as well. While significant efforts are directed toward improving diagnosis and risk-stratification, best evidence-guided practices remain in evolution. Data about anesthetic management of patients with coronary anomalies are lacking as well. This review aims to provide the anesthesiologist with a better understanding of an important subgroup of coronary artery anomalies: anomalous aortic origin of a coronary artery. We will discuss classification, pathophysiology, incidence, evaluation, management, and anesthetic implications of this potentially fatal disease group.

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Ischaemic heart disease: coronary artery anomalies

10.1093/med/9780198726012.003.0030 ◽

2016 ◽

Author(s):

Eugenio Picano ◽

Fausto Pinto ◽

Blazej Michalski

Keyword(s):

Coronary Artery ◽

Coronary Arteries ◽

Cardiac Death ◽

Incidental Finding ◽

Superior Vena ◽

Vena Cava ◽

Coronary Anomalies ◽

Coronary Artery Anomalies ◽

Venous Structure ◽

Coronary Artery Segment

Coronary anomalies occur in less than 1% of the general population and their clinical presentation can range anywhere from a benign incidental finding to the cause of sudden cardiac death. Since congenital coronary arteries anomalies are often considered as the first cause of cardiac death in young athletes in Europe, careful attention has to be paid in this specific subpopulation in case of suggestive symptoms. Although focused expert echocardiography is the first-line imaging tool, coronary computed tomography or radiation-free magnetic resonance imaging are recommended for more definitive definition of the coronary course in persons suspected of having coronary artery anomalies. Most coronary anomalies belong to the group of anomalous origin. Aneurysms are defined as dilations of a coronary vessel 1.5 times the normal adjacent coronary artery segment. Coronary artery fistulas are communications between one or more coronary arteries and a cardiac chamber (coronary-cameral), the pulmonary artery, or a venous structure (such as the sinus or superior vena cava).

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