Congenital coronary artery anomalies in the adult: a new practical viewpoint.

There is a certain confusion as to the universal classification of coronary artery anomalies (CAAs), since the existing classifications are often fragmented and difficult to apply as they combine many anatomical, angiographic, and clinical elements. A practical global classification of CAAs for diagnostic and clinical purposes has not been proposed previously. The authors propose to describe CAAs on the basis of seven angiographic patterns (1: hypoplasia/atresia, 2: hyperdominance, 3: fistula, 4: originating from other arteries, 5: originating from the wrong sinus, 6: splitting, and 7: tunneling) and four clinical significance classes (benign--class A, relevant--class B, severe--class C, and critical--class D). This global classification can be applicable to almost all significantCAAs, and in the authors' view it might help both angiographers and clinical cardiologists to familiarize themselves rapidly with a comprehensive description of most CAAs by simplifying the transmission of the angiographic data.