Hippokratia 2012; 16(3):246-249

N. Sivri, M. Aktoz, K. Yalta, F. Ozcelik, A. Altun

Abstract

Background: Congenital anomalies of the coronary arteries are rarely encountered in patients undergoing cardiac catheterization. In patients undergoing coronary angioplasty or cardiac surgery, angiographic recognition of coronary anomalies is important for the proper management of these patients.
Method: We retrospectively reviewed the records of 12,844 patients who had previously undergone coronary angiography in the catheterization laboratory of Trakya University Cardiology Department over the past 14 years. We tried to investigate the presence of a variety of coronary anomalies in these patients to determine the prevalence of various types of anomalies and their anatomic variation in a selected population of the European part of Turkey. The potential association between coronary atherosclerosis and congenital coronary anomalies was also investigated.
Results: Among these patients, 95 patients were found to have major coronary anomalies that predominantly comprised anomalous aortic origin of coronary arteries. Among the major anomalies, anomalous aortic origin of the left circumflex (LCX) artery from the right sinus of Valsalva or right coronary artery (RCA) was found to be the the most prevalent (46 out of 95 patients) outnumbering the second most common anomaly that was anomalous aortic origin of the RCA (32 out of 95 patients). In the present study, the incidence of major coronary arterial anomaly was found to be 0.74 %. However, only about one third of the patients (31 out of 95, 32.6%) with major anomaly had significant coronary atherosclerotic lesions among whom nine were found to involve the LCX artery with a posterior course.
Conclusion: The incidence of congenital coronary anomalies in a selected population of the European part of Turkey is similar to those of other populations. Congenital coronary anomalies generally present as isolated anomalies and are not associated with an increased risk of coronary atherosclerosis in this series. Cardiologists and surgeons should be familiar with these entities for the proper management of patients undergoing cardiac surgery or coronary angioplasty.

Read PDF