title: Congenital coronary anomalies of origin and distribution in adults: a coronary arteriographic study.
abstract: BACKGROUND
  Coronary anomalies should be recognized to avoid problems during coronary intervention and cardiac surgery.
  
  
  RESULTS
  We retrospectively reviewed 7400 coronary angiograms to find out the pattern and incidence of coronary anomalies of origin and distribution. We excluded patients with congenital heart diseases, coronary artery fistulae and patients with separate origin of the conus artery. and found 34 cases (0.46%) (22 males), mean age 50.7 +/- 12 years with coronary anomalies. Six cases underwent angiography prior to valve replacement and the rest were part of the evaluation for atherosclerotic coronary artery disease. The most common anomaly was separate origins of the left anterior descending coronary artery and left circumflex coronary artery [n=12 (35.3%)]. The next most common anomalies were origins of the right coronary artery from the left coronary sinus [n=7 (20.6%)] and left circumflex artery from the right sinus [n=6 (20%)]. A single coronary artery was seen in 3 cases (8.8%) which included one case of postmyocardial infarction ventricular septal rupture with triple-vessel disease, and another with two small coronary fistulae. One case each of the following coronary anomalies was found: (i) double right coronary artery, (ii) left anterior descending coronary artery from the right coronary sinus, (iii) all three coronary arteries originating separately from the right sinus, and (iv) left main coronary artery from the right sinus. Of these 34 patients, 11 (32.4%) had significant atherosclerotic disease in the anomalous vessel.
  
  
  CONCLUSIONS
  The incidence of primary coronary anomaly seems to be less than that in earlier reports, but the pattern of anomalies appears to be similar.
authors.affiliation: Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala. drharikrishnan@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Harikrishnan
authors.forename: Sonney P
authors.initials: SP
authors.lastname: Jacob
authors.forename: Jaganmohan
authors.initials: J
authors.lastname: Tharakan
authors.forename: Thomas
authors.initials: T
authors.lastname: Titus
authors.forename: V K Ajith
authors.initials: VK
authors.lastname: Kumar
authors.forename: Anil
authors.initials: A
authors.lastname: Bhat
authors.forename: S
authors.initials: S
authors.lastname: Sivasankaran
authors.forename: Francis
authors.initials: F
authors.lastname: Bimal
authors.forename: K M Krishna
authors.initials: KM
authors.lastname: Moorthy
authors.forename: R Padma
authors.initials: RP
authors.lastname: Kumar
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies