CORONARY ARTERY ANOMALIES;

AN AFIC/NIHD EXPERIENCE

Abstract

Introduction: Congenital anomalies of the coronary arteries occur in 0.2% to 1.2% of the general
population . The incidence of various coronary anomalies and associated clinical, angiographic and hemodynamic 1
findings have been cited in several internationally published clinical series . To compare our experience with 4-8
previously reported studies, we have reviewed clinical and angiographic findings for 50 adult patients with coronary
artery anomalies. Patients and Methods: We surveyed the records of 5050 consecutive adult patients who had
undergone coronary angiography.Setting: Armed Forces Institute of Cardiology and National Institute of Heart Disease
(AFIC/NIHD) Rawalpindi. Period: 1 Jan 2004 and 30 April 2005, and identified 50 adults with various coronary artery st th
anomalies. Results: 5050 reports were reviewed and 50 (0.9%) coronary artery anomalies were identified in 50
patients. Different anomalies identified are; both coronary arteries from right sinus of Valsalva (RSV)-(n = 1), both
coronary arteries arising from the left coronary sinus (n = 4), single coronary arteries (n = 2), LCx from RSV/RCA (n=6),
anterior descending artery arising from the right coronary sinus (n = 1), coronary artery fistulae (n = 4), separated origin
of anterior descending and left circumflex coronary arteries (n = 25), and separate origin of conus/ RV branch (n = 7).
The initial course was retroaortic in all the circumflex arteries, interarterial in the right coronaries, and anterior in the
anterior descending arteries. Conclusions: We conclude that adult congenital anomalies of the coronary arteries are
not uncommon finding in a tertiary care cardiac center. Separate origin of LAD and LCx from LSV and left circumflex
coronary artery arising from RSV/RCA are the most frequently diagnosed anomalies.