Normal and anomalous coronary arteries: Definitions and classification

Angelini, Paolo

doi:10.1016/0002-8703(89)90789-8

Cited by 378 publications

(351 citation statements)

References 258 publications

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“…These data as well as the results of a registry analysing coronary angiograms of 126 595 consecutive patients did not suggest a significant correlation between coronary anomalies and the incidence of atherosclerotic plaque [13]. Should atherosclerosis occur in the common trunk of a single artery, however, the clinical consequences would usually be serious, because the dependent myocardial territory includes the whole heart and no collateral circulation can develop [14].…”

Section: Discussionmentioning

confidence: 83%

Rescue percutaneous transluminal coronary angioplasty in a patient with a single coronary artery arising from the right Sinus Valsalvae: previously unreported scenario and review of literature

Zweiker

Luha

Klein

2002

Journal of Internal Medicine

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This is the first description of treatment with coronary stenting of a patient with a single coronary artery originating from the right Sinus Valsalvae and suffering from acute inferior myocardial infarction. Angiography showed the following: the right coronary artery (RCA) had a normal course, whilst the left anterior descending (LAD) as well as the left circumflex (LCX) branches both originated separately from the proximal RCA, which served as a common mixed trunk. The LAD crossed to the left in front of the right ventricular outflow tract, whilst the LCX, taking a retroaortic course to the atrioventricular groove, had a distal occlusion. According to an anatomically based classification considering all imaginable variations, this configuration corresponds to a II-D-1 pattern, which previously has been described only in a single postmortem case. After the LCX was reopened with a guide wire, a coronary stent was successfully inserted, resulting in TIMI-3 flow. Recovery was uneventful.

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Section: Discussionmentioning

confidence: 83%

Rescue percutaneous transluminal coronary angioplasty in a patient with a single coronary artery arising from the right Sinus Valsalvae: previously unreported scenario and review of literature

Zweiker

Luha

Klein

2002

Journal of Internal Medicine

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“…Although CAAs are rare with reported prevalences of 0.3 to 5.64% of patients undergoing invasive coronary angiography and 0.3 to 0.5% of autopsies, they can be responsible for cardiovascular morbidity and even mortality. [10][11][12] Malignant anomalies may have serious implications such as angina pectoris, myocardial infarction, syncope, cardiac arrhythmias, congestive heart failure, or sudden death. 13 Especially in the young, coronary anomalies are an important cause of sport-related sudden cardiac death.…”

Section: Coronary Artery Anomaliesmentioning

confidence: 99%

Coronary artery anomalies detected by MSCT-coronary angiography in the adult

Kate¹,

Weustink²,

Feyter³

2008

NHJL

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Background. Before coronary evaluation by modern imaging techniques was feasible, premorbid diagnoses of coronary artery anomalies (CAAs) were usually made fortuitously by invasive coronary angiography (ICA). However, this technique is limited by its invasive and projectional nature. Coronary magnetic resonance angiography (CMRA) and multi-slice computed tomography (MSCT) broadened clinical information by enabling visualisation of the coronary arteries in their anatomical environment. Methods. This case series visualises and reviews anomalous coronary artery from the opposite sinus (ACAOS) and coronary artery fistulae. All CAAs were detected by means of 64-slice dual source computed tomography after 1000 cardiac scans at the Erasmus MC, Rotterdam, the Netherlands. Results. Eight ACAOS cases, one anomalous left coronary artery from the pulmonary artery (ALCAPA) and one congenital aneurysm of an aortic sinus were found. Seven out of ten detected CAAs were considered malignant whereas three CAAs of the ACAOS type (retroaortic path) were considered benign. Significant coronary artery disease was found in three out of eight ACAOS cases. In one of the ACAOS cases complete evaluation of the anomalous coronary artery was limited by motion artifacts. All five cases of right ACAOS were referred for MSCT because the right coronary artery could not be located by invasive angiography. Keywords: coronary anomalies, anomalous coronary artery from the opposite sinus, coronary artery fistulae, computed tomography, invasive coronary angiography Conclusion. All CAAs

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“…2 In the proposed case, the two branches originated at the right sinus of Valsalva single ostium and go to the posterior/inferior wall of the left ventricle, a territory that could be either of the RCA (which would be called dominant, in such case) or of the circumflex (which would be called dominant, in such case). Since both coronary branches originated from the right sinus of Valsalva, the two should be considered part of a dominant RCA: the unusual feature was the presence of two separate branches supplying the posterior descending territory.…”

mentioning

confidence: 94%

“…I contend that the entity they describe is actually neither rare (indeed, it is the most frequent of coronary anomalies, being 1.23% of a continuous series of a general population, if one uses defined criteria of normality and anomalies and performs prospective studies), 2 nor is it a case of two RCAs. The case is indeed one of ''split right coronary artery.''…”

mentioning

confidence: 98%