A clinical-angiographic risk scoring system for coronary artery anomalies.
Congenital coronary anomalies remain a debated issue. On the basis of a critical review of the literature and our historical series, we propose a simple clinical profile scoring system for congenital coronary anomalies. A review of literature over the past 30 years was performed, searching for a relationship between the worst coronary anomaly presentation and manifestations and the anatomical and functional features. A risk scoring system was created based on these features, and retrospectively applied to our historical series of 140 consecutive patients (52 females; mean age, 60.1±19.3 years; mean follow-up, 60±23 months). Origin from the pulmonary artery, intramural course, intramyocardial course, coronary fistula with a significant pulmonary-to-systemic flow ratio, superimposed coronary artery disease, and associated congenital heart disease were associated with the worst clinical presentation. The risk scoring system gave 2 points to anatomical features and 1 point to the association with clinical and functional characteristics: 3 risk classes were identified: >3, 2-3, and <2 points. The system showed good correlation with presentation and manifestations on follow-up. Although not exhaustive, the proposed scoring system may simplify the clinical evaluation of patients with such abnormalities, being a model for decision making.
Section of Adult Congenital Heart Disease Interventions, Rovigo, General Hospital, Rovigo, Italy. jackyheart71@yahoo.it
Gianluca
G
Rigatelli
Alberto
A
Rigatelli
Sandra
S
Cominato
Stefano
S
Panin
Nguyen Thuong
NT
Nghia
Giuseppe
G
Faggian
D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011652:Pulmonary Circulation; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index