DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162299

A study of incidence and pattern of coronary artery anomalies in Western Rajasthan, India

Satish Lingaraju, Rakesh Kumar Maurya, Sanjeev Sanghvi

Abstract


Background: Coronary artery anomalies (CAAs) are a diverse group of congenital disorders whose manifestations and pathophysiological mechanisms are highly variable. Among patients undergoing coronary angiography, the incidence depends on the population studied and the criteria used to define an anomaly. This is the first ever study conducted in western Rajasthan to detect the incidence and pattern of coronary anomalies.

Methods: We retrospectively studied 8500 coronary angiographies (CAG) done in the institution over a period of 12 years from 2004 to 2015 for detection of incidence and pattern of coronary anomalies. Patients with ischemic heart disease and valvular heart disease who underwent CAG were included in the study.

Results: Out of the 8500 angiograms screened a total of 108 coronary anomalies were detected (incidence of 1.27%). Anomalies of origin and course was the most common anomaly (106 out of 108 patients) followed by anomalies of  coronary termination (fistulas) which was seen in just two patients. Most common anomaly was absent left main artery with separate origin of the left anterior descending (LAD) artery and left circumflex artery (LCx) (n=36, 33.3%), followed closely by anomalous origin of right coronary artery (RCA) from left sinus (n=34, 31.48%). Anomalous origin of LCx from right sinus/ RCA was the third most common anomaly (n=22, 20.37%). Other rare anomalies include anomalous origin of left coronary artery from right coronary sinus (n=6, 5.55%), RCA from posterior sinus (n=4, 3.7%). Single coronary artery, LAD from RCA and coronary artery fistula were seen in two patients each (n=2, 1.85%).

Conclusions: In present study though the total incidence of coronary anomalies was similar to that in other studies, the pattern of coronary anomalies was slightly different from that reported from different parts of the world.

 


Keywords


Coronary artery anomalies, Anomalous origin, Coronary artery fistula, Aortic sinus

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References


Yamanaka O, Hobbs RE. Coronary artery anomalies in 1,26,595 patients undergoing coronary arteriography. Cath Cardiovasc Diagn. 1990;21:28-40.

Angelini P, Velasco JA, Flamm S. Coronary anomalies: Incidence, pathophysiology, and clinical relevance. Circulation. 2002;105:2449-54.

Kurjia HZ, Chaudhry MS, Olson TR. Coronary artery variation in a native Iraqi population. Cathet Cardiovasc Diagn.1986;12:386-90.

Topaz O, DiSciascio G, Cowley MJ, Soffer A, Lanter P, Goudreau E, et al. Absent left main coronary artery: angiographic findings in 83 patients with separate ostia of the left anterior descending and circumflex arteries at the left aortic sinus. Am Heart J. 1991;122:447-52.

Garg N, Tewari S, Kapoor A, Gupta DK, Sinha N. Primary congenital anomalies of the coronary arteries: a coronary: arteriographic study. Int J Cardiol. 2000;74:39-46.

Aydinlar A, Ciçek D, Sentürk T. Primary congenital anomalies of the coronary arteries: a coronary arteriographic study in Western Turkey. Int Heart J. 2005;46:97-103.

Barriales Villa R, Morís C, López Muñiz A, Hernández LC, San Román L, Barriales Alvarez V, et al. [Adult congenital anomalies of the coronary arteries described over 31 years of angiographic studies in the Asturias Principality: main angiographic and clinical characteristics]. Rev Esp Cardiol. 2001;54:269-81.

Harikrishnan S, Jacob SP, Tharakan J, Titus T, Kumar VK, Bhat A, et al. Congenital coronary anomalies of origin and distribution in adults: a coronary arteriographic study. Indian Heart J. 2002;54:271-5

Garg N, Tewari S, Kapoor A, Gupta DK, Sinha N. Primary congenital anomalies of the coronary arteries: a coronary: arteriographic study. Int J Cardiol. 2000;74:39-46.

Ouali S, Neffeti E, Sendid K, Elghoul K, Remedi F, Boughzela E. Congenital anomalous aortic origins of the coronary arteries in adults: a Tunisian coronary arteriography study. Arch Cardiovasc Dis. 2009;102: 201-8.

Correia E, Ferreira P, Rodrigues B. Prevalence of anomalous origin of coronary arteries: a retrospective study in a Portuguese population. Rev Port Cardiol. 2010;29:221-9.

Göl MK, Ozatik MA, Kunt A, Iscan Z, Yavas S, Soylu M, et al. Coronary artery anomalies in adult patients. Med Sci Monit. 2002;8:CR636-41.

Roberts WC, Shirani J. The four subtypes of anomalous origin of the left main coronary artery from the right aortic sinus (or from the right coronary artery). Am J Cardiol. 1992;70:119e21.

Chu E, Cheitlin MD. Diagnostic considerations in patients with suspected coronary artery anomalies.Am Heart J. 1993;126:1427e38.

Atak R, Güray U, Akin Y. Images in cardiology: Intercoronary communication between the circumflex and right coronary arteries: distinct from coronary collaterals. Heart. 2002;88:29.