Study of the Prevalence of Congenital Coronary Anomalies of Origin from the Opposite or Non-coronary Sinus in patients undergoing Invasive Coronary Angiography

OBJECTIVES

1. To study the incidence and clinical features of patients with Congenital Coronary Anomalies of Origin from Oppossite or Non-coronary Sinus; 2. To study the course of these Anomalous Coronary Artery Origins with CT Coronary Angiography.

METHODS

A Cross Sectional Observation study was conducted at Department of Cardiology, in a tertiary Hospital for a period of 3 years. Patients undergoing Coronary Angiography (CAG) were screened and patients having Anomalous Coronary Origin from the Opposite or Non-Coronary Sinus of Valsalva were selected. CT Cronary Angiography was done in all such patients and the course of the anomalous artery was studied.

RESULTS

During the 3 years period of study, total of 5241 CAGs were conducted of which 42 (0.8%) patients were found to have Anomalous Coronary Artery Origin as per the inclusion criteria. Out of the 42 cases, Anomalous origin of RCA from Left Corornary Cusp was the commonest with 23(0.43%) cases, followed by Anomalous Origin of LCX from Right Coronary or RCC with 17 (0.32%) cases. Other anomalies of origin were quite rare (n=2) which included Anomalous origin of Left Main from RCA (n=1) and Dual origin of LAD (n=1). CT Coronary Angiography showed that of the 23 patients with Anomalous Origin of RCA from Left side,27.4% had Inter-Arterial course and 56.1% had Retro-Aortic course. Of the 17 patients with Anomalous Origin of LCX from Right sinus, 88.23% had Retro-Aortic course.

CONCLUSIONS

This study showed that anomalous origin of Coronary Artery from the opposite sinus is quite rare with RCA from Left Sinus and LCX from Right sinus comprised the vast majority of cases. Most of these anomalous Coronaries have on benign course as defined on CT Coronary Angiography. However, it is important to recognize to delineate the origin and course as it can have significant clinical, therapeutic and prognostic implications.

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