BACKGROUND: The aim of this study was to evaluate the incidence of coronary artery anomalies in a homogeneous population undergoing coronary angiography, and to assess acute and follow-up results of coronary angioplasty (PTCA). METHODS: From September 2001 to May 2010, 23 complex coronary artery anomalies were observed among 6300 patients undergoing coronary angiography (0.36%) at our cath lab. Mean age of the study population (20 males, 3 females) was 61.8 years (range 35-79 years). Seventeen patients presented with acute coronary syndrome associated with severe coronary stenosis, and 6 patients showed angina and ventricular arrhythmias associated with inducible ischemia on stress testing and no coronary artery lesions. PTCA was performed in 16 patients, 9 of whom with an anomalous origin of the coronary artery. RESULTS: The most frequent coronary artery anomaly was the anomalous origin of the right coronary artery from the left coronary cusp, running between the aorta and the pulmonary artery (n = 10, 8 males, 2 females; PTCA of the anomalous coronary artery performed in 4 cases). Eight patients showed an anomalous origin of the circumflex artery arising from the right coronary artery with a retroaortic course (PTCA of the anomalous coronary artery performed in 4 cases), and 2 patients (1 male, 1 female) an anomalous origin of the left main coronary artery from the right coronary cusp with a septal course. The remaining 3 patients showed an isolated anomalous origin of the left coronary artery from the right coronary artery with interarterial course, the left anterior descending artery from the right coronary artery, and the left anterior descending artery from the right coronary cusp, respectively. CONCLUSIONS: PTCA proved to be effective in the treatment of coronary artery anomalies showing no procedure-related complications and stable results over time. The high number of coronary artery anomalies in our study patients may help estimating the actual incidence of these anomalies in the Italian population by providing a rationale for implementing a national registry.
BACKGROUND: The aim of this study was to evaluate the incidence of coronary artery anomalies in a homogeneous population undergoing coronary angiography, and to assess acute and follow-up results of coronary angioplasty (PTCA). METHODS: From September 2001 to May 2010, 23 complex coronary artery anomalies were observed among 6300 patients undergoing coronary angiography (0.36%) at our cath lab. Mean age of the study population (20 males, 3 females) was 61.8 years (range 35-79 years). Seventeen patients presented with acute coronary syndrome associated with severe coronary stenosis, and 6 patients showed angina and ventricular arrhythmias associated with inducible ischemia on stress testing and no coronary artery lesions. PTCA was performed in 16 patients, 9 of whom with an anomalous origin of the coronary artery. RESULTS: The most frequent coronary artery anomaly was the anomalous origin of the right coronary artery from the left coronary cusp, running between the aorta and the pulmonary artery (n = 10, 8 males, 2 females; PTCA of the anomalous coronary artery performed in 4 cases). Eight patients showed an anomalous origin of the circumflex artery arising from the right coronary artery with a retroaortic course (PTCA of the anomalous coronary artery performed in 4 cases), and 2 patients (1 male, 1 female) an anomalous origin of the left main coronary artery from the right coronary cusp with a septal course. The remaining 3 patients showed an isolated anomalous origin of the left coronary artery from the right coronary artery with interarterial course, the left anterior descending artery from the right coronary artery, and the left anterior descending artery from the right coronary cusp, respectively. CONCLUSIONS: PTCA proved to be effective in the treatment of coronary artery anomalies showing no procedure-related complications and stable results over time. The high number of coronary artery anomalies in our study patients may help estimating the actual incidence of these anomalies in the Italian population by providing a rationale for implementing a national registry.
Authors: Satish Karur; Soumya Patra; Ravindranath K Shankarappa; Navin Agrawal; Ravi S Math; Manjunath C Nanjappa Journal: J Cardiovasc Dis Res Date: 2013-10-15