title: Prevalence and characteristics of coronary artery anomalies detected by coronary computed tomography angiography in 5 634 consecutive patients in a single centre in Switzerland.
abstract: Coronary computed tomography angiography (CCTA) allows three-dimensional visualisation of the origin, course and ending of the coronary vessels with high spatial resolution, yielding an accurate depiction of coronary artery anomalies (CAAs). This study sought to determine the prevalence, incidence and characteristics of CAAs detected with CCTA in a single centre in Switzerland.
  
  
  METHODS
  CAAs were retrospectively identified in 5 634 consecutive patients referred for CCTA between March 2007 and July 2015. Single coronary arteries, Bland-White-Garland syndrome, anomalous coronary arteries originating from the opposite site of the sinus of Valsalva (ACAOS) with an interarterial course and coronary artery fistulas were classified as potentially malignant CAAs.
  
  
  RESULTS
  We identified 145 patients with CAAs, resulting in an overall prevalence of 2.6% and cumulative incidence of 2.1% in all patients referred for CCTA in the observation period. Forty-nine (33.8%) patients showed malignant CAAs including 1 (0.7%) patient with Bland-White-Garland syndrome, 7 (4.8%) with single coronary arteries, 36 (24.8%) with ACAOS and an interarterial course, and 5 (3.5%) with coronary artery fistulas. The remaining 96 (66.2%) patients were classified as having benign variants.
  
  
  CONCLUSIONS
  The prevalence of CAA detected by CCTA is not negligible. Because of its noninvasive nature, relatively low cost and low radiation exposure, a further increase in the utilisation of CCTA may be expected, which may consequently be paralleled by an increasing absolute number of incidentally detected CAAs. Hence, awareness of the main issues and possible management strategies regarding CAAs is of importance for every treating physician.
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Gräni
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Dominik C
authors.initials: DC
authors.lastname: Benz
authors.affiliation: Department of Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Schmied
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Jan
authors.initials: J
authors.lastname: Vontobel
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Mathias
authors.initials: M
authors.lastname: Possner
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Olivier F
authors.initials: OF
authors.lastname: Clerc
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Fran
authors.initials: F
authors.lastname: Mikulicic
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Stehli
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Tobias A
authors.initials: TA
authors.lastname: Fuchs
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Aju P
authors.initials: AP
authors.lastname: Pazhenkottil
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland; Department of Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Oliver
authors.initials: O
authors.lastname: Gaemperli
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Kaufmann
authors.affiliation: Department of Nuclear Medicine, Cardiac Imaging, University Hospital Zurich, Switzerland.
authors.forename: Ronny Ralf
authors.initials: RR
authors.lastname: Buechel
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D058070:Asymptomatic Diseases; D063748:Bland White Garland Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology; D015331:Cohort Studies; D017023:Coronary Angiography; D003330:Coronary Vessel Anomalies / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D004417:Dyspnea / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D013557:Switzerland / Q000453:epidemiology; D013575:Syncope / Q000209:etiology; D014057:Tomography, X-Ray Computed; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology