title: The clinical anatomy of high take-off coronary arteries.
abstract: A number of criteria are used in the literature to describe high take-off coronary arteries, which can in part, explain the divide in the literature on the pathological significance of this anomaly. This study presents the anatomical variations of high take-off coronary arteries to draw attention to the possible clinical implications they may cause during angiography and other surgical procedures. The English Literature was searched to review high take-off coronary arteries. A high take-off coronary artery arising at least 1 cm in adults or 20% the depth of the sinus in children above the sinutubular junction, is considered of greater clinical relevance and was included in our meta-analysis. High take-off coronaries by other criteria was also included as part of the comprehensive review. Exclusion criteria were reports made in case studies or case reviews. The prevalence of high take-off coronary arteries in our study was 26 of 12,899 (0.202%). High take-off coronary arteries were found to originate up to 5 cm above the sinutubular junction. Right coronary arteries made up 84.46% of high take-off coronary arteries reported in the literature. Three (0.023%) cases that originated more than one centimeter above the sinutubular junction was associated with sudden cardiac death. This is a higher reported association than in studies that used other criteria for classification. It is important for clinicians to recognize the importance of correctly diagnosing high take-off coronary arteries in patients with coexisting cardiac morbidities so that suitable management plans can be developed.
authors.affiliation: Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.
authors.forename: Rebecca G
authors.initials: RG
authors.lastname: Andall
authors.affiliation: Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.
authors.forename: Akbar Z
authors.initials: AZ
authors.lastname: Khan
authors.affiliation: Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.
authors.forename: Kush
authors.initials: K
authors.lastname: Patel
authors.affiliation: Department of Cardiovascular Surgery, The University Hospital of Bucharest, Romania.
authors.forename: Horia
authors.initials: H
authors.lastname: Muresian
authors.affiliation: Department of Pediatrics-Cardiology, University of Florida, Gainesville, Florida and Congenital Heart Institute of Florida, St. Petersburg, Florida.
authors.forename: Diane E
authors.initials: DE
authors.lastname: Spicer
authors.affiliation: Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.|Children's Hospital, Pediatric Neurosurgery, Birmingham, Alabama.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
mesh_terms: D063405:Anatomic Variation; D003331:Coronary Vessels / Q000033:anatomy & histology*; D047108:Embryonic Development; D006801:Humans
keywords: anomalies of aortic origin; coronary arterial anomalies; sudden cardiac death