Angiographic Study of Anatomical Variations of Coronary Arteries by Using Diagnostic Catheter

Abstract

Introduction:The coronary arteries may present several anomalies, in terms of both number and position. New image-based diagnostic techniques have led to greater reliability in the identification of these anomalies.Aim of the work:this work is done to study the angiographic pattern of normal coronary arteries variations by using the diagnostic catheter.Material and Methods: Any patient enlisted for angiography in catheterization lab in Zagazig University Hospital was enrolled in this study.Results: Data of 4246 patients who underwent coronary angiography were analysed. 115 patients who had anomalous of coronary arteries were entered into final data analysis.The following data could be concluded: The overall incidence of primary congenital coronary anomalies was 2.7% (115 out of 4,246 patients) in our angiographic population, of whom 86 were males (74.7%) and 29 were females (25.3%). The mean age was (45.95 ± 11.65) years. Anomalous LCX was the most common coronary anomaly being present in 35 patients (0.82%). The second most common anomaly was myocardial bridge and it was present in 31 patients (0.73%). Anomalous RCA was present in eighteen patients (15.65%). Left main coronary artery was absent in two cases (1.7%) and it has anomalous origin from right coronary sinus (RCS) in another two cases (1.7%). On the other hand, anomalous LAD was present in 8 patients (6.95 %). Coronary aneurysms were observed in 10 cases (7.82%). On the other hand, coronary fistulas were diagnosed in nine cases (8.7%). The incidence of coronary anomalies among cases with coronary artery detected disease was 72.2% (83 cases) while this incidence among those without angiographically detected coronary artery disease was 27.8% (32 cases). Hence, the frequency of coronary artery anomaly was significantly higher among patients with CAD than those without CAD (P < 0.0001). Conclusion:Coronary artery anomaly is a common anomaly between the populations. It could be the only cause of chest pain without significant coronary lesion.

Incidence, Characteristics and Atherosclerotic Involvement of Coronary Artery Anomalies in Adult Population Undergoing Catheter Coronary Angiography

“…In our study fistulae were seen in six cases, with an incidence of 0.18%. This incidence rate is similar to that seen in many studies, such as by Yamanaka and Hobbs (0.17%), Tharwat et al (0.21%), Namgung and Kim (0.15%) [2, 23, 37]. In our study RCA was the most common site of origin of coronary fistulae, and pulmonary artery was the most common site of termination.…”

“…The incidence in the largest angiographic study by Yamanaka and Hobbs was 1.30%, while it was 5.64% in the prospective study by Angelini et al using strict diagnostic criteria [2, 10]. The incidence in our study was 3.06%, being higher than most of the previous studies but consistent with a few of these [10, 23, 28, 29]. Our results are closer to the prospectively conducted study by Angelini et al than most of the previous studies.…”

“…The incidence of CAAs in the available literature (Table 5 [2, 3, 7-13, 23, 24, 27-29, 35-38]) is highly variable, and depends on several factors like characteristics of study population, definitions used and the type of imaging modality used. The incidence of CAAs in major angiographic studies has been reported to be 0.6% to 5.64% [2-13].…”

“…Atherosclerotic involvement of anomalous coronaries as compared to normal coronaries is also a subject of active research with few studies showing increased susceptibility of anomalous coronaries to atherosclerosis as compared to normal coronaries [23, 24].…”

Primary percutaneous coronary intervention with diagnostic catheter in an anomalous origin right coronary artery—a case report

“…The risk associated with AOCA depends upon the anatomical path taken by the artery to its perfusion territory [ 2 ]. The association of coronary artery disease (CAD) in CAA is not clear; AOCA has been shown to be associated with an increase incidence of atherosclerotic CAD [ 3 ], while no such association could be established in other abnormalities like coronary artery ectasia [ 4 ] although most of the patients presented with symptoms of typical angina.…”