Primary congenital anomalies of the coronary arteries and relation to atherosclerosis: an angiographic study in Lebanon.
BACKGROUND
Most coronary artery anomalies are congenital in origin. This study angiographically determined the prevalence of different forms of anomalous aortic origins of coronary anomalies and their anatomic variation in a selected adult Lebanese population. Correlation between these anomalies and stenotic coronary atherosclerotic disease was also investigated.


METHODS
4650 coronary angiographies were analyzed for anomalous aortic origin. These anomalies were clustered in four main groups: anomalous left circumflex (LCX) coronary artery, anomalous right coronary artery, anomalous left main coronary artery and anomalous left anterior descending coronary artery.


RESULTS
Thirty four patients had anomalous aortic origin of coronary arteries. Of these, anomalous LCX coronary artery was the most common (19 of 34 patients). The second most common anomaly was anomalous RCA origin (9 of 34 patients.) The incidence of coronary stenosis in non-anomalous vessels was 50%. However, a significantly smaller percentage (17.46%; 6 of 34 patients) of anomalous vessels exhibited significant stenosis, reminiscent of atherosclerotic disease. Of these six vessels, five were LCX coronary artery arising from right coronary sinus or from early branch of right coronary artery. The sixth was right coronary artery arising from left coronary sinus.


CONCLUSIONS
The incidence of congenital coronary anomalies in Lebanon is similar to other populations where the most common is the LCX coronary artery. Isolated congenital coronary anomalies do not increase the risk of developing coronary stenosis or atherosclerosis. Angiographic detection of these anomalies is clinically important for coronary angioplasty or cardiac surgery.
Eid
Ali H
AH
Department of Biology, College of Science, United Arab Emirates University, Al-Ain, UAE. alieid@uaeu.ac.ae
Itani
Ziad
Z
Al-Tannir
Mohammad
M
Sayegh
Said
S
Samaha
Ali
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D007861:Lebanon / Q000453:epidemiology; D008297:Male; D008875:Middle Aged