title: Coronary anatomy, anatomic variations and anomalies: a retrospective coronary angiography study.
abstract: BACKGROUND
  The incidence of coronary artery anomalies (CAAs) varies from 0.2% to 8.4%. Knowledge of such anatomical variations is important as coronary procedures are regularly performed these days. We aimed to find the coronary dominance pattern, intermediate artery (IMA) frequency and CAA incidence in our clinic, and compare them to those in the literature.
  
  
  METHODS
  The medical reports of 5,548 patients who had undergone coronary angiography (CAG) between 2005 and 2009 were retrospectively investigated. Dominance pattern and presence of IMA and CAA were recorded. CAAs were described using two different classifications: Angelini and Khatami's classification, and a new modified classification that was derived from Angelini and Khatami's classification. Some procedural details and clinical features of the patients with CAA were also investigated.
  
  
  RESULTS
  Coronary dominance pattern was: 81.6% right coronary artery, 12.2% circumflex artery and 6.2% co-dominant. IMA was present in 613 (11.0%) patients. The incidences of overall anomaly were 2.7% and 1.4%, according to the different classifications. Absent left main coronary artery, which was the most common anomaly in the present study, was found in 51 (0.9%) patients. Incidences of myocardial bridge, coronary arteriovenous fistulae and aneurysms were 1.1%, 0.2% and 0.3%, respectively.
  
  
  CONCLUSIONS
  CAAs are generally asymptomatic, isolated lesions. Some may lead to anginal symptoms, myocardial infarction or sudden death. We found that CAA was associated with increased radiation and contrast exposure in patients who underwent CAG. This risk could be reduced if appropriate catheters were designed and training programmes on ostial cannulation were developed.
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Altin
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Suleyman
authors.initials: S
authors.lastname: Kanyilmaz
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Sahbender
authors.initials: S
authors.lastname: Koc
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Yusuf Cemil
authors.initials: YC
authors.lastname: Gursoy
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Uğur
authors.initials: U
authors.lastname: Bal
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Alp
authors.initials: A
authors.lastname: Aydinalp
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Aylin
authors.initials: A
authors.lastname: Yildirir
authors.affiliation: Department of Cardiology, Faculty of Medicine, University of Başkent, Ankara, Turkey.
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
mesh_terms: D000328:Adult; D000368:Aged; D063405:Anatomic Variation; D000783:Aneurysm; D001164:Arteriovenous Fistula; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis; D003330:Coronary Vessel Anomalies / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000033:anatomy & histology* / Q000601:surgery; D003645:Death, Sudden; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction; D009206:Myocardium / Q000473:pathology; D012189:Retrospective Studies
keywords: anomalies; coronary anatomy; incidences; variations