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Yan W, He Z, Luo Y, Huang W, Zhu B, Zhong Y, Wang X. Prevalence and characteristics of coronary artery fistulas among 20 259 patients undergoing invasive coronary angiography. Coron Artery Dis 2024; 35:135-142. [PMID: 38206811 DOI: 10.1097/mca.0000000000001327] [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: 01/13/2024]
Abstract
BACKGROUND Coronary artery fistula (CAF) is a rare coronary anomaly. This study aimed to investigate the prevalence, clinical features, and imaging characteristics of CAF among patients undergoing coronary angiography (CAG). METHOD This was a retrospective study including 20 259 consecutive patients (12 458 were male) who underwent CAG at our institution from September 2018 to March 2023. Electronic angiography records were reviewed, and a total of 86 (0.42%) CAF patients were enrolled and analyzed. RESULT Of the 86 CAF patients, 42 (49%) were male. Thus, the prevalence of CAF for males and females was 0.34% and 0.56%, respectively. Arrhythmia, left ventricular (LV) hypertrophy, LV dilation, and LV systolic dysfunction were observed in 38, 25, 10 and 5 cases, respectively. Among the 86 CAF patients, a total of 117 CAFs were detected. 61 (71%) patients had a single CAF, and the remaining 25 (29%) patients had multiple CAFs. Of the 117 CAFs, the most common origins and terminations were the left anterior descending artery (n = 50) and the pulmonary artery (n = 73), respectively. The CAF diameters were greatly varied, ranging from unmeasurable to 7.8 mm, and 22 (18%) CAFs were larger than 3 mm. CONCLUSION In the present study, the prevalence of CAF was 0.42% with a female predilection. Arrhythmia, LV remodeling and dysfunction were common. Seventy-one percent of patients had a single CAF. The left anterior descending artery and the pulmonary artery were the most common origin and termination of CAFs, respectively. Most CAFs were small, and 18% of CAFs were larger than 3 mm.
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Affiliation(s)
- Wei Yan
- Department of Cardiology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
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Kashyap JR, Kumar S, Reddy S, Rao K R, Sehrawat O, Kashyap R, Kansal M, Reddy H, Kadiyala V, Uppal L. Prevalence and Pattern of Congenital Coronary Artery Anomalies in Patients Undergoing Coronary Angiography at a Tertiary Care Hospital of Northern India. Cureus 2021; 13:e14399. [PMID: 33981512 PMCID: PMC8108404 DOI: 10.7759/cureus.14399] [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] [Indexed: 11/22/2022] Open
Abstract
Objectives: To evaluate the prevalence and pattern of congenital coronary artery anomalies (CAAs) in the adult population undergoing catheter coronary angiography. Methods: The coronary angiograms done between October 2015 and September 2020 were reviewed for the presence of coronary anomalies based upon Angelini's classification. The medical record of patients with anomalies was reviewed for symptomatology and indication of angiography. Results: CAAs were found in 129 (87 males and 42 females) of 6,258 patients giving a prevalence of 2.06%. The mean age was 57.8 ± 11.8 (range 32-81) years. Among these, the anomalous origin and course of the coronaries were the most common anomaly seen in 81 (1.29%) patients, followed by intrinsic anomalies of the coronary arterial system in 44 (0.7%) patients and anomalies of coronary termination and anomalous anastomotic vessels in 2 (0.03%) patients each. Overall, the absence of the left main trunk with a separate origin of the left anterior descending (LAD) and the circumflex artery was the commonest anomaly seen in 46 (0.74%) patients, followed by dual LAD in 35 (0.56%) patients. The anomalous origin of the right coronary artery (RCA) from the left sinus was seen in 14 patients (0.22%) and that of the circumflex artery from the right sinus or right coronary artery was seen in 11 patients (0.17%). The origin of the left main and RCA from ascending aorta was found in eight (0.13%) patients. One (0.02%) patient had a single coronary artery, and another one (0.02%) had all the three coronary arteries arising from the right sinus; however, with separate ostia. The split RCA was seen in nine (0.14%) patients and there were two (0.03%) patients each of coronary artery fistulae, and of anomalous anastomotic vessels. Conclusions: The prevalence of congenital coronary anomalies in this study was 2.06%. The commonest anomaly was that of origin and courses of the vessels, however, the pattern of anomalies is different from previous studies.
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Affiliation(s)
- Jeet Ram Kashyap
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Suraj Kumar
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Sreenivas Reddy
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Raghavendra Rao K
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Ojasav Sehrawat
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Rashmi Kashyap
- Community Medicine, Dr Yashwant Singh Parmar Government Medical College, Nahan, IND
| | - Maninder Kansal
- General Medicine, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Hithesh Reddy
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Vikas Kadiyala
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
| | - Lipi Uppal
- Cardiology, Government Medical College and Hospital, Chandigarh, Chandigarh, IND
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Sidhu NS, Wander GS, Monga A, Kaur A. Incidence, Characteristics and Atherosclerotic Involvement of Coronary Artery Anomalies in Adult Population Undergoing Catheter Coronary Angiography. Cardiol Res 2019; 10:358-368. [PMID: 31803334 PMCID: PMC6879043 DOI: 10.14740/cr941] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Accepted: 10/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background Coronary artery anomalies (CAAs) are rare disorders of coronary anatomy with varied clinical presentations. There are widespread geographic variations in incidence and patterns of these anomalies, with limited data from North Indian population. We performed a retrospective study to evaluate the incidence, characteristics and atherosclerotic involvement of CAAs in adult population undergoing catheter coronary angiography. Methods Serial coronary angiographies performed at our institution over a period of 2.5 years (from January 2017 to June 2019) were retrospectively analyzed. We identified patients with anomalous coronaries and studied their clinical characteristics and angiographic profiles. Results Among 3,233 coronary angiograms analyzed, CAAs were found in 99 patients with an incidence of 3.06%. Mean age of the patients was 56.2 ± 12.9 years (range: 20 - 86 years), with 74.75% being males and 25.25% females. Split right coronary artery (RCA) was the most common coronary anomaly, being seen in 27 patients; with an angiographic incidence of 0.84%. Dual left anterior descending artery (LAD) was the second most common anomaly and was seen in 22 cases with an angiographic incidence of 0.68%. Absent left main trunk was noted in 14 patients (0.43%). Ectopic origin of RCA from left sinus was seen in 12 patients (0.37%), while ectopic origin of RCA from ascending aorta was seen in four patients (0.12%). Ectopic origin of left circumflex artery (LCX) from right sinus or RCA was noted in 13 patients (0.40%). One patient (0.03%) had a superdominant LAD supplying the posterior descending artery (PDA). Coronary artery fistulae were seen in six patients (0.18%). Significant coronary artery disease (CAD) was seen in 89 of 268 (33.21%) normal vessels, whereas it was seen in 56 of 114 (49.12%) of anomalous vessels. This difference was statistically significant (P = 0.003). Conclusions The incidence of CAAs in our study was slightly higher than many of the previous angiographic series. The patterns of coronary anomalies in our study were different from most of the previous studies. Our study had higher incidence of atherosclerotic involvement of anomalous vessels as compared to normal vessels.
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Affiliation(s)
- Navdeep Singh Sidhu
- Department of Cardiology, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Gagandeep Singh Wander
- Department of Cardiology, Medanta-the-Medicity, Gurugram, Haryana, India (formerly at Department of Cardiology, GGS Medical College and Hospital, Faridkot, Punjab, India)
| | - Anmol Monga
- Department of Medicine, GGS Medical College and Hospital, Faridkot, Punjab, India
| | - Arashdeep Kaur
- Department of Medicine, GGS Medical College and Hospital, Faridkot, Punjab, India
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Koza Y, Tas H, Aydemir S. Percutaneous Coronary Intervention in A Rare Case of Single Coronary Ostium Presented with ST Elevation Myocardial Infarction. Eurasian J Med 2019; 51:307-309. [PMID: 31692699 DOI: 10.5152/eurasianjmed.2019.18436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 02/28/2019] [Indexed: 11/22/2022] Open
Abstract
Anomalous aortic origin of the left coronary artery (AAOLCA) from the right sinus of Valsalva is a very rare coronary anomaly that can lead to sudden cardiac death (SCD), usually during or after strenuous exercise. The anatomical variation can follow five different courses: interarterial, subpulmonic (intraconal or intraseptal), prepulmonic, retroaortic, or retrocardiac. The interarterial variation is the pattern that has a stronger relationship with SCD. In patients with AAOLCA, ST-segment elevation myocardial infarction (STEMI) is a rare clinical presentation, and the management of an anomalous infarct-related coronary artery may be technically challenging. We report a case of a patient with an AAOLCA who presented with inferior STEMI and who underwent a successful percutaneous coronary intervention of the right coronary artery.
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Affiliation(s)
- Yavuzer Koza
- Department of Cardiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Hakan Tas
- Department of Cardiology, Ataturk University School of Medicine, Erzurum, Turkey
| | - Selim Aydemir
- Department of Cardiology, Ataturk University School of Medicine, Erzurum, Turkey
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Al-Umairi RS, Al-Kindi F, Al-Tai S. Prevalence and Spectrum of Coronary Anomalies Detected on Coronary Computed Tomography Angiography: A single centre experience in Oman. Sultan Qaboos Univ Med J 2019; 19:e108-e113. [PMID: 31538008 PMCID: PMC6736262 DOI: 10.18295/squmj.2019.19.02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/26/2018] [Accepted: 01/28/2019] [Indexed: 12/13/2022] Open
Abstract
Objectives Coronary artery anomalies (CAAs) are uncommon congenital abnormalities with a prevalence ranging from 0.2–2%. CAAs can be asymptomatic or less commonly present with life-threatening symptoms. This study aimed to investigate the prevalence and spectrum of CAAs in patients who underwent coronary computed tomography angiography (CCTA) in Oman. Methods This retrospective study was conducted at the National Heart Centre, Muscat, Oman between September 2012 and August 2018. All consecutive patients who had undergone CCTA were included. Results A total of 4,445 patients were included in this study. Of these, 59 patients (1.3%) were diagnosed with CAAs with a mean age of 52.6 years (range: 12–80 years) and an equal gender distribution. Among the patients with CAAs, the majority (69.5%) had anomalous origins from the opposite or non-coronary sinus. Right coronary artery arising from the left coronary sinus was the most common type (33.9%). Fewer patients (18.6%) had left circumflex arising from the right coronary sinus (RCS). Seven patients (11.9%) had left main arising from the RCS. Other CAAs were in the dual left anterior descending artery (8.5%), high coronary artery take-off (6.8%), single coronary ostia (6.8%) and coronary artery fistula (6.8%). Conclusion The prevalence of CAAs was 1.3% which is similar to the literature.
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Affiliation(s)
| | | | - Saqar Al-Tai
- Department of Radiology, Royal Hospital, Muscat, Oman
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6
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Doustkami H, Habibzadeh A. Successful Ostial Stenting in a Patient with a Single Coronary Artery from the Right Sinus of Valsalva: A Case Report. J Tehran Heart Cent 2018; 13:140-143. [PMID: 30745928 PMCID: PMC6368912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Single coronary arteries (SCAs) constitute a rare coronary anomaly which is usually asymptomatic. However, SCAs may become symptomatic and even cause myocardial ischemia and infarction and as such necessitate proper intervention whether percutaneous or surgical. We describe an 89-year-old woman with an SCA from the right sinus of Valsalva presenting with chest pain and acute myocardial infarction. We succeeded in performing percutaneous coronary intervention and stenting on the ostial lesion of the SCA, and there were no further complications. The patient was discharged 2 days later with no adverse complications.
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Affiliation(s)
- Hossein Doustkami
- Department of Cardiology, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Afshin Habibzadeh
- Department of Internal Medicine, Ardabil University of Medical Sciences, Ardabil, Iran.,Corresponding Author: Afshin Habibzadeh, Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran. 5618985991. Tel: +98 45 33522391. Fax: +98 45 33522391.E-mail: .
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7
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Abstract
BACKGROUND Coronary artery anomalies are a heterogeneous group of congenital disorders presenting with a wide spectrum of symptoms, ranging from vague chest pain to sudden cardiac death. Despite available data, there is no consensus about the classification, nomenclature, and outcomes of coronary anomalies in the normally connected heart. In this study, we aimed to investigate clinical and angiographic characteristics of coronary arterial anomalies, as well as the frequency of atherosclerotic involvement in anomalous coronaries, diagnosed at a tertiary referral centre. METHODS We retrospectively reviewed coronary angiograms performed between 2011 and 2015 for the presence of a coronary anomaly. A total of 111 patients with a final diagnosis of coronary anomaly were included in the study group. We also recruited 110 age- and sex-matched patients who underwent coronary angiography because of symptomatic coronary artery disease as controls. RESULTS Among 36,893 coronary angiograms, 111 (0.30%) major coronary anomalies were found. Compared with controls, the prevalence of significant atherosclerotic coronary disease was lower in patients with coronary anomalies and stable symptoms (p=0.02); however, the prevalence of significant coronary atherosclerosis was similar among patients admitted with unstable angina or myocardial infarction (p>0.05). Compared with controls, patients with an anomalous left anterior descending coronary artery had significantly less atherosclerotic involvement than those in whom the left anterior descending artery was not anomalous (p=0.005). CONCLUSIONS Although coronary artery anomalies are cited as a cause for myocardial ischaemia, atherosclerotic coronary artery disease is also frequent and may offer an alternative explanation to ischaemic symptoms. No predisposition to accelerated atherosclerosis was found, however, and atherosclerotic involvement was less frequent in some anomalous vessels.
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Smettei OA, Sayed S, Abazid RM. The prevalence of coronary artery anomalies in Qassim Province detected by cardiac computed tomography angiography. J Saudi Heart Assoc 2017; 29:84-89. [PMID: 28373781 PMCID: PMC5366662 DOI: 10.1016/j.jsha.2016.07.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Revised: 07/22/2016] [Accepted: 07/27/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Coronary artery anomalies (CAAs) affect about 1% of the general population based on invasive coronary angiography (ICA) data, computed tomography angiography (CTA) enables better visualization of the origin, course, relation to the adjacent structures, and termination of CAAs compared to ICA. OBJECTIVE The aim of our work is to estimate the frequency of CAAs in Qassim province among patients underwent cardiac CTA at Prince Sultan Cardiac Center. METHODS Retrospective analysis of the CTA data of 2235 patients between 2009 and 2015. RESULTS The prevalence of CAAs in our study was 1.029%. Among the 2235 patients, 241 (10.78%) had CAAs or coronary variants, 198 (8.85%) had myocardial bridging, 34 (1.52%) had a variable location of the Coronary Ostia, Twenty two (0.98%) had a separate origin of left anterior descending (LAD) and left circumflex coronary (LCX) arteries, ten (0.447%) had a separate origin of the RCA and the Conus artery. Seventeen (0.76%) had an anomalous origin of the coronaries. Six (0.268%) had a coronary artery fistula, which is connected mainly to the right heart chambers, one of these fistulas was complicated by acute myocardial infarction. CONCLUSIONS The incidence of CAAs in our patient population was similar to the former studies, CTA is an excellent tool for diagnosis and guiding the management of the CAAs.
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Affiliation(s)
- Osama A. Smettei
- Department of Cardiology, Cardiac Imaging Department, Prince Sultan Cardiac Center Al-Qassim, Buraydah, aSaudi Arabia
- Corresponding author at: Department of Cardiology, Prince Sultan Cardiac Center-Qassim, Postal code 2290 Buraydah, Al-Qassim Province, Saudi Arabia.Department of CardiologyPrince Sultan Cardiac Center-QassimPostal code 2290 BuraydahAl-Qassim ProvinceSaudi Arabia
| | - Sawsan Sayed
- Department of Cardiology, Cardiac Imaging Department, Prince Sultan Cardiac Center Al-Qassim, Buraydah, aSaudi Arabia
| | - Rami M. Abazid
- Department of Cardiology, Cardiac Imaging Department, Prince Sultan Cardiac Center Al-Qassim, Buraydah, aSaudi Arabia
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Paul AD, Avadhani R, Subramanyam K. Anomalous origins and branching patterns in coronary arteries – An angiographic prevalence study. J ANAT SOC INDIA 2016. [DOI: 10.1016/j.jasi.2016.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Low radiation dose computed tomography coronary angiography: evaluation of the variations in coronary arteries. Surg Radiol Anat 2016; 38:1123-1134. [DOI: 10.1007/s00276-016-1693-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/08/2016] [Indexed: 11/26/2022]
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Acute Anterior Myocardial Infarction Accompanied by Acute Inferior Myocardial Infarction: A Very Rare Coronary Artery Anomaly. Case Rep Cardiol 2015; 2015:347126. [PMID: 26161273 PMCID: PMC4475525 DOI: 10.1155/2015/347126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 05/17/2015] [Accepted: 05/28/2015] [Indexed: 11/18/2022] Open
Abstract
Coronary artery anomalies are rare and mostly silent in clinical practice. First manifestation of this congenital abnormality can be devastating as syncope, acute coronary syndrome, and sudden cardiac death. Herein we report a case with coronary artery anomaly complicated with ST segment myocardial infarction in both inferior and anterior walls simultaneously diagnosed during primary percutaneous coronary intervention.
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12
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Otlu YÖ, Bayramolu A, Hidayet Ş, Ermiş N. Transradial Percutaneous Coronary Intervention in a Patient with a Rare Coronary Anomaly: Twin Circumflex Arteries. ACTA CARDIOLOGICA SINICA 2015; 31:72-4. [PMID: 27122849 DOI: 10.6515/acs20140310d] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
UNLABELLED Coronary artery anomalies are rare in population and most of them are found incidentally during coronary angiography. Percutaneous treatment of critical lesions on anomalous arteries may lead to difficulties due to their abnormal origin or course. Herein, we report a 65-year-old male patient presented with recent onset chest pain. Electrocardiogram and transthoracic echocardiography were in normal range. Treadmill exercise test revealed ST segment depression in lead V4-V6. Angiography revealed an unusual coronary anomaly: twin circumflex arteries originating from left main coronary artery and same orifice of right coronary artery, respectively. There was a significant stenosis on the right sided circumflex artery, which was treated percutaneously via transradial access. KEY WORDS Coronary artery anomalies; Percutaneous coronary intervention; Transradial access; Twin circumflex arteries.
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Affiliation(s)
| | - Adil Bayramolu
- Department of Cardiology, Elbistan State Hospital, Kahramanmaraş
| | - Şıho Hidayet
- Department of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Necip Ermiş
- Department of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey
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Imori Y, Murakami M, Tanaka M, Saito S. Anomalous origin of the right coronary artery with concomitant myxomatous mitral valve disease: a rare coexistence. BMJ Case Rep 2014; 2014:bcr-2014-206351. [PMID: 25342190 DOI: 10.1136/bcr-2014-206351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 45-year-old man previously diagnosed with myxomatous mitral valve disease was admitted to our hospital with chest pain at rest and on effort. Contrast-enhanced CT revealed that the patient's right coronary artery originated from the left sinus Valsalva, which was compressed between the aortic and pulmonary roots. This anatomical abnormality can be associated with sudden death, syncope and chest pain. Ultrasonography showed mitral valve prolapse with severe regurgitation. Surgical repair was performed, which included coronary artery bypass graft and mitral valvoplasty with tricuspid annuloplasty. The postoperative course was uneventful and the patient remains asymptomatic. This is the first description of the coexistence of an anomalous origin of the right coronary artery with myxomatous mitral valve disease.
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Affiliation(s)
- Yoichi Imori
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Masato Murakami
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Masashi Tanaka
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
| | - Shigeru Saito
- Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan
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Namgung J, Kim JA. The prevalence of coronary anomalies in a single center of Korea: origination, course, and termination anomalies of aberrant coronary arteries detected by ECG-gated cardiac MDCT. BMC Cardiovasc Disord 2014; 14:48. [PMID: 24725604 PMCID: PMC3991863 DOI: 10.1186/1471-2261-14-48] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 04/08/2014] [Indexed: 11/10/2022] Open
Abstract
Background Coronary anomalies are rare congenital abnormalities often found incidentally on conventional coronary angiography (CCA) or coronary CT angiography (CTA). They may result in various clinical outcomes. CCA is invasive and not able to demonstrate all coronary anomalies in detail, especially those with complex courses. Multidetector computed tomography (MDCT) enables visualization of the origin and course of coronary arteries. The objective of this study was to investigate the prevalence of origin and termination coronary artery anomalies and the course of these anomalies in patients in a single center in Korea. Methods To diagnose coronary anomalies, the angiographic data of 8,864 consecutive patients undergoing 64- or 320-MDCT from September 2005 to November 2011 were analyzed retrospectively. Results Among the 8,864 patients, 103 (1.16%) had coronary anomalies. Ninety (87.4%) patients had origin and distribution anomalies, and 13 (12.6%) patients had a coronary artery fistula. The most common anomaly (41, 39.8%) was an anomalous origin of the right coronary artery (RCA). Of these, three patients received a coronary artery bypass graft. Conclusions The prevalence of coronary anomalies in a single center of Korea was 1.16%. The incidence and patterns of coronary artery anomalies in our patient population were similar to those of previous studies.
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Affiliation(s)
- June Namgung
- Division of Cardiology, Department of Internal Medicine, Vision 21 Cardiac & Vascular Center, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, 170 Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do 411-706, Republic of Korea.
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15
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Karur S, Patra S, Shankarappa RK, Agrawal N, Math RS, Nanjappa MC. Percutaneous coronary intervention in patients with anomalous origin of coronary artery presenting with acute coronary syndrome: A case series. J Cardiovasc Dis Res 2013; 4:204-8. [PMID: 24396264 DOI: 10.1016/j.jcdr.2013.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 08/21/2013] [Indexed: 10/26/2022] Open
Abstract
Coronary artery anomalies are found in 0.6%-1.5% of patients undergoing diagnostic coronary angiogram. Intervention in these patients poses a particular technical challenge secondary to the aberrancies in the vessel origin and course. From March 2011 to February 2013, 13 cases with complex coronary artery anomalies were observed among 2482 patients undergoing CAG (0.52%) at our cath lab. Only three patients had severe stenosis in the anomalous artery sufficient to require an intervention and had presented with myocardial infarction. PCI was performed successfully in these 3 patients two of which had anomalous left circumflex artery and the other having an anomalous right coronary artery.
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Affiliation(s)
- Satish Karur
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
| | - Soumya Patra
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
| | - Ravindranath K Shankarappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
| | - Navin Agrawal
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
| | - Ravi S Math
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
| | - Manjunath C Nanjappa
- Department of Cardiology, Sri Jayadeva Institute of Cardiovascular Sciences & Research, Bangalore, Karnataka 560069, India
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