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Serafini L, Piazzani M, Madureri A, Giacomarra G, Elia S, Chizzola G, Metra M, Adamo M. Anomalous origin of the coronary arteries: a brief summary for clinical practice. J Cardiovasc Med (Hagerstown) 2024; 25:364-369. [PMID: 38555582 DOI: 10.2459/jcm.0000000000001607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Affiliation(s)
- Lisa Serafini
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia
| | | | | | | | - Stefano Elia
- Radiology Unit, ASST Valcamonica, Esine, Brescia, Italy
| | - Giuliano Chizzola
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia
| | - Marco Metra
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia
| | - Marianna Adamo
- Institute of Cardiology, ASST Spedali Civili, Department of Medical and Surgical specialties, Radiological sciences and Public Health, University of Brescia
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Kiyoshima D, Tanaka O, Terayama H, Qu N, Nagahori K, Ueda Y, Yamamoto M, Suyama K, Hayashi S, Sakabe K. Right and Left Coronary and Conus Arteries Originating from Three Separate Ostia in the Right Valsalva Sinus in a Japanese Cadaver: A Case Study with Literature Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:730. [PMID: 38792913 PMCID: PMC11123433 DOI: 10.3390/medicina60050730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/20/2024] [Accepted: 04/24/2024] [Indexed: 05/26/2024]
Abstract
A rare case of an anomalous location of the orifice of the coronary artery was found in a 99-year-old male cadaver undergoing routine dissection. The presence of the right coronary artery (RCA), left coronary artery (LCA), and conus artery (conus branch) originating from the right Valsalva sinus are the characteristic findings of this case. Then, the LCA passed through the aorta and the pulmonary artery. The LCA and RCA branches were normal. These findings are useful for future surgical procedures, including cardiac catheterization.
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Affiliation(s)
- Daisuke Kiyoshima
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Osamu Tanaka
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Hayato Terayama
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
- Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Ning Qu
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
- Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Kenta Nagahori
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Yoko Ueda
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Masahito Yamamoto
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Kaori Suyama
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
| | - Shogo Hayashi
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
- Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Kou Sakabe
- Department of Anatomy, Division of Basic Medical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara-si 259-1193, Kanagawa, Japan; (D.K.); (O.T.); (N.Q.); (K.N.); (Y.U.); (M.Y.); (K.S.); (S.H.)
- Department of Anatomy, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
- Department of Environmental Preventive Medicine, Yamada Bee Company, Inc., Center for Preventive Medical Sciences, Chiba University, 1-33 Yayoicho, Inage-ku, Chiba-si 263-8522, Chiba, Japan
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Papakonstantinou NA, Leontiadis E, Katsaridis SD, Milonakis M, Avgerinos D, Papadopoulos K, Malakos I, Stavridis GT. Anomalous circumflex artery: a benign variant generating a malignant potential after valve surgery. Coron Artery Dis 2023; 34:364-371. [PMID: 37139563 DOI: 10.1097/mca.0000000000001247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Coronary artery anomalies are a diverse group of congenital disorders presenting with highly variable clinical manifestations. The anomalous origin of left circumflex artery from the right coronary sinus following a retro-aortic trajectory is a well-recognized anatomic variation. Despite its benign course, it can prove lethal in association with valvular surgery. When single aortic valve replacement or combined with mitral valve replacement is performed, the aberrant coronary vessel may be compressed by or between the prosthetic rings triggering postoperative lateral myocardial ischemia. If left untreated, the patient is at risk of sudden death or myocardial infarction with its detrimental complications. Skeletonization and mobilization of the aberrant coronary artery is the most widely accepted intervention, but valve downsizing or concomitant surgical or transcatheter revascularization have also been described. However, large series are lacking from the literature. Therefore, no guidelines exist. This study is a thorough review of the literature concerning the aforementioned anomaly in association with valvular surgery.
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Affiliation(s)
- Nikolaos A Papakonstantinou
- 3 Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece
- Division of Cardiovascular Surgery, Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network and University of Toronto, Toronto, Ontario, Canada
| | | | | | - Michael Milonakis
- 3 Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitrios Avgerinos
- 3 Cardiac Surgery Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Kyrillos Papadopoulos
- Department of Cardiac Surgery Intensive Care Unit, Onassis Cardiac Surgery Center, Athens, Greece
| | - Ioannis Malakos
- lnterventional Cardiology Department, Onassis Cardiac Surgery Center
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An entire coronary system arising from right coronary cusp: a rare anomaly. J Community Hosp Intern Med Perspect 2019; 9:362-364. [PMID: 31528292 PMCID: PMC6735346 DOI: 10.1080/20009666.2019.1650603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 07/25/2019] [Indexed: 11/22/2022] Open
Abstract
The prevalence of coronary artery anomalies is approximately 0.6% in individuals undergoing angiography. Most of the anomalies are benign, but some can lead to myocardial infarction, cardiomyopathy, and sudden cardiac death. It is very rare to have an entire coronary circulation that arises from the right coronary cusp. We present a case of a 57-year-old male who presented with complaints of chest pain and dyspnea on exertion. An invasive angiogram revealed all the three coronary arteries originating from the right coronary cusp. It is crucial to define coronary anatomy as anomalies dictate which cardiac intervention should be attempted in cases of ischemia.
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Anatomical variants and coronary anomalies detected by dual-source coronary computed tomography angiography in North-eastern Thailand. Pol J Radiol 2018; 83:e372-e378. [PMID: 30655913 PMCID: PMC6334062 DOI: 10.5114/pjr.2018.78420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 08/28/2018] [Indexed: 12/18/2022] Open
Abstract
Purpose Congenital coronary anomalies are uncommon, with an incidence ranging from 0.17% in autopsy cases to 1.2% in angiographically evaluated cases. The recent development of dual-source coronary computed tomography angiography (coronary CTA) allows accurate and noninvasive depiction of coronary artery anomalies. Material and methods A retrospective study included a total of 924 patients who underwent coronary CTA because of known or suspected coronary artery disease. In each study, coronary artery anomalies (CAs) were investigated. Results A total of 924 patients (mean age 51.2 ± 12.8 years), who underwent dual-source coronary CTA, were studied. The overall prevalence of CAs in our study was 3.7%, with the following distribution: four single coronary artery, 14 anomalous origin from opposite sinus of Valsalva, three absent left main, four high take-off coronary artery, three anomalous left coronary artery from pulmonary artery, and eight coronary artery fistulas. Conclusions The present study supports the use of coronary CTA as a reliable noninvasive tool for defining anomalous coronary arteries in an appropriate clinical setting and provides detailed three-dimensional anatomic information that may be difficult to obtain with invasive coronary angiography.
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Quadriostial Origin of 4 Coronary Arteries From the Right Coronary Sinus of Valsalva. JACC Cardiovasc Interv 2018; 11:503-504. [DOI: 10.1016/j.jcin.2017.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Revised: 10/30/2017] [Accepted: 11/07/2017] [Indexed: 11/21/2022]
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Ibrahim M, Rabjohns R, Kurtz SC, Malik MF. The 'all-right' man: a case of three coronary arteries all arising from the right sinus of Valsalva. BMJ Case Rep 2016; 2016:bcr-2015-214171. [PMID: 26818814 PMCID: PMC4735435 DOI: 10.1136/bcr-2015-214171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Majd Ibrahim
- Department of Internal Medicine/Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Centre, Peoria, Illinois, USA
| | - Ronald Rabjohns
- Department of Internal Medicine/Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Centre, Peoria, Illinois, USA
| | - Stephen Craig Kurtz
- Department of Internal Medicine/Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Centre, Peoria, Illinois, USA
| | - Muhammad Fayaz Malik
- Department of Internal Medicine/Cardiology, University of Illinois College of Medicine at Peoria/OSF Saint Francis Medical Centre, Peoria, Illinois, USA
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Pasaoglu L, Toprak U, Nalbant E, Yagiz G. A rare coronary artery anomaly: origin of all three coronary arteries from the right sinus of valsalva. J Clin Imaging Sci 2015; 5:25. [PMID: 25973289 PMCID: PMC4421887 DOI: 10.4103/2156-7514.156137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 04/15/2015] [Indexed: 11/04/2022] Open
Abstract
Left anterior descending (LAD) artery and left circumflex (LCx) coronary artery originating separately from the right sinus of valsalva is exceptionally rare and very few cases have been reported in the literature. Congenital coronary artery anomalies are generally incidental, uncommon, and asymptomatic. Some can cause severe potentially life-threatening symptoms such as myocardial ischemia and sudden cardiac death. The aberrant vessels that pass between the aorta and the pulmonary trunk pose a risk of sudden cardiac death, particularly if the vessel supplies the left coronary artery network. The electrocardiographically gated multi-detector computed tomography (MDCT) allows accurate and non-invasive depiction of coronary artery anomalies including origin, course, and termination. We report here a rare case of all three coronary arteries separately originating from the right coronary sinus, which was detected with MDCT.
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Affiliation(s)
- Lale Pasaoglu
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Ugur Toprak
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Emre Nalbant
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Gokhan Yagiz
- Department of Radiology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Yuan SM. Anomalous origin of coronary artery: taxonomy and clinical implication. Braz J Cardiovasc Surg 2014; 29:622-9. [PMID: 25714217 PMCID: PMC4408826 DOI: 10.5935/1678-9741.20140109] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/14/2014] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Anomalous origin of coronary artery is uncommon. The taxonomies of anomalous origin of coronary artery are inconsistent and complex. Conceptual and therapeutic debates remain. The aim of the present study is to reappraise the concept of anomalous origin of coronary artery and to discuss the potential hazards and treatment rationale of this anomaly on basis of literature review. METHODS A comprehensive literature review was made in terms of the taxonomies including "simple", "multiple" and "complex" types of anomalous origin of coronary artery. RESULTS Anomalous origin of coronary artery can be simply categorized according to the ectopically originated coronary artery. There are a couple of complex anatomical variants: "multiple" type, involving more than one coronary artery or branch, which can be subdivided into 2 subtypes, A) more than one coronary arteries or branches arising from one place; and B) two coronary arteries/branches arising from separate ectopic sites; and "complex" type, associated with acquired heart disease, or congenital heart defects. CONCLUSION Sudden cardiac death in anomalous origin of coronary artery is associated with the anatomical features including abnormal coursing, acute angle take-off and ostial abnormalities. Atherosclerosis is prone to be in the right-sided ectopic and retroaortic coursing coronary artery. Surgical treatment is a definitive therapy. Simple coronary artery bypass grafting is not recommended due to the potential hazards of coronary steal phenomenon and poor patency of mammary arterial grafts, and modified maneuvers such as coronary ostial reimplantation, impinged coronary segment unroofing and coronary stent deployment are advocated instead.
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Affiliation(s)
- Shi-Min Yuan
- The First Hospital of Putian, Teaching Hospital, Fujian
Medical University, Putian, Fujian Province, People’s Republic of China
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Deora S, Shah S, Patel T. Origin of all three coronaries separately from right sinus of valsalva - A rare anomaly. J Cardiol Cases 2012; 7:e18-e20. [PMID: 30533110 DOI: 10.1016/j.jccase.2012.09.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2012] [Revised: 08/31/2012] [Accepted: 09/10/2012] [Indexed: 11/16/2022] Open
Abstract
Anomalous coronary artery origin from opposite sinus is uncommon and separate origin of all three coronary arteries from right sinus of valsalva is exceptionally rare. The anomaly may cause ischemia due to atherosclerosis or due to altered ostial configuration, its exit angulations from the aorta, route of the artery, and intussuception. Various imaging modalities such as echocardiography, coronary angiography, computed tomography, and magnetic resonance imaging have been used to diagnose origin and course of anomalous coronary arteries. Management includes medical treatment and percutaneous or surgical revascularization. Percutaneous coronary intervention is technically challenging and needs judicious selection of guide catheters. We report a patient who presented with inferior wall myocardial infarction and separate origin of all three coronaries from right sinus of valsalva with successful percutaneous revascularization.
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Affiliation(s)
- Surender Deora
- Department of Cardiovascular Sciences, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Gujarat University, Ahmedabad, Gujarat 380006, India
| | - Sanjay Shah
- Department of Cardiovascular Sciences, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Gujarat University, Ahmedabad, Gujarat 380006, India
| | - Tejas Patel
- Department of Cardiovascular Sciences, Sheth V.S. General Hospital, Smt. N.H.L. Municipal Medical College, Gujarat University, Ahmedabad, Gujarat 380006, India
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Panduranga P, Al-Mukhaini M. Absent left main with anomalous origin of all three coronary arteries from left aortic sinus: a previously undescribed combination of coronary anomalies. Heart Lung Circ 2012; 21:824-7. [PMID: 22627084 DOI: 10.1016/j.hlc.2012.04.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Revised: 04/01/2012] [Accepted: 04/02/2012] [Indexed: 11/27/2022]
Abstract
Coronary artery anomalies resulting in all three coronary arteries arising separately from single sinus of Valsalva is very rare. We report a patient with two coincidental coronary anomalies: absent left main with left anterior descending, and left circumflex arteries arising separately from left sinus of Valsalva along with anomalous origin of right coronary artery from left sinus of Valsalva. Computed tomography angiogram and conventional coronary angiogram showed anomalous right coronary artery from left sinus with an interarterial course, but with no significant lesions. However, there was significant stenosis of left anterior descending and circumflex arteries that was treated with angioplasty and stenting. To the best of our knowledge, absent left main with all three major coronary arteries arising separately from left aortic sinus has never been reported previously.
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Sayin MR, Aydin M, Dogan SM, Karabag T. Percutaneous Coronary Intervention on Right Coronary Artery With All Coronary Arteries From Three Separate Ostiums in the Right Sinus of Valsalva. Cardiol Res 2011; 2:196-197. [PMID: 28352392 PMCID: PMC5358230 DOI: 10.4021/cr29e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2011] [Indexed: 11/03/2022] Open
Abstract
Some of coronary artery anomalies, such as origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, represent a small amount of coronary anomalies. We describe a 63-year-old female patient which coronary angiogram revealed an origin of all coronary arteries from three separate ostiums in the right sinus of valsalva, with significant atherosclerotic plaque at the midportion of the right coronary artery. The stenosis was treated through percutaneous coronary intervention.
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Affiliation(s)
- Muhammet Rasit Sayin
- Zonguldak Karaelmas University, School of Medicine, Department of Cardiology, Kozlu 67600, Zonguldak, Turkey
| | - Mustafa Aydin
- Zonguldak Karaelmas University, School of Medicine, Department of Cardiology, Kozlu 67600, Zonguldak, Turkey
| | - Sait Mesut Dogan
- Zonguldak Karaelmas University, School of Medicine, Department of Cardiology, Kozlu 67600, Zonguldak, Turkey
| | - Turgut Karabag
- Zonguldak Karaelmas University, School of Medicine, Department of Cardiology, Kozlu 67600, Zonguldak, Turkey
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Al-Mohaissen M, Heilbron B, Leipsic J, Ignaszewski A. Anomalous origin of the entire coronary system by three separate ostia within the right coronary sinus--a rarely observed coronary anomaly. Can J Cardiol 2010; 26:206-8. [PMID: 20548983 DOI: 10.1016/s0828-282x(10)70401-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The anomalous origin of the entire coronary system by three separate ostia within the right coronary sinus is a very rare anomaly with only 34 cases reported in the literature to date. A patient with this rare anomaly who developed coronary artery disease, requiring revascularization, is presented. His coronary computed tomography angiography and coronary angiographic findings are discussed. The present case demonstrates the complimentary roles of coronary computed tomography angiography and conventional cardiac catheterization in managing a patient with anomalous coronary arteries and coronary artery disease.
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Affiliation(s)
- Maha Al-Mohaissen
- Department of Cardiology, St. Paul's Hospital and University of British Columbia, Vancouver, BC, Canada.
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Joshi SD, Joshi SS, Athavale SA. Origins of the coronary arteries and their significance. Clinics (Sao Paulo) 2010; 65:79-84. [PMID: 20126349 PMCID: PMC2815286 DOI: 10.1590/s1807-59322010000100012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2009] [Accepted: 10/20/2009] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To describe the normal and variant anatomy of the coronary artery ostia in Indian subjects. INTRODUCTION Anomalous coronary origins may cause potentially dangerous symptoms, and even sudden death during strenuous activity. A cadaveric study in an unsuspected population provides a basis for understanding the normal variants, which may facilitate determination of the prevalence of anomalies and evaluation of the value of screening for such anomalies. METHODS One hundred and five heart specimens were dissected. The number of ostia and their positions within the respective sinuses were observed. Vertical and circumferential deviations of the ostia were observed. The heights of the cusps and the ostia from the bottom of the sinus were measured. RESULTS No openings were present in the pulmonary artery or the non-coronary sinus. The number of openings in the aortic sinuses varied from 2-5 in the present series; multiple ostia were mostly seen in the anterior sinus. The majority of the ostia lay below the sinutubular ridge (89%) and at or above the level of the upper margin of the cusps (84%). Left ostial openings were mainly centrally located (80%), whereas the right coronary ostia were often shifted towards the right posterior aortic sinus (59%). DISCUSSION The preferential location of the ostia was within the sinus and above the cusps, but below the sinutubular ridge. On occasion, normal variants like multiple ostia, vertical or circumferential shift in the position, and slit-like ostia may create confusion in interpreting the images and pose a difficulty during procedures like angiography, angioplasty, and coronary artery bypass grafting.
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Affiliation(s)
- Subhash D. Joshi
- Anatomy Department, Rural Medical College, Loni, dist Ahmednagar - Maharashtra/Indian
| | - Sharda S. Joshi
- Anatomy Department, Rural Medical College, Loni, dist Ahmednagar - Maharashtra/Indian
| | - Sunita Arvind Athavale
- Anatomy Department, KVG Medical College, Kurunjibag Sullia DK District, Sullia - Karnataka/Indian
- , Tel: 00 91 9886484455
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