Incidence of coronary anomaly in coronary angiography

Kim, Ju Sung; Kim, Myung Su; Jeung, Ho Seuk; Ryoo, Eun Sang; Hyun, Min Su; Kim, Sung Gu; Kwon, Young Joo

Abstract

BACKGROUND: Coronary anomalies are found incidentally, in which anatomy is altered but physiology is normal; that is, coronary blood flow is normal. However, certain anomalies are associated with myocardial ischemia or infarction, heart failure, and sudden death.
METHODS
From February 1988 to February 2000, 3534 cases have been catheterized, among them we experienced 28 cases of coronary anomalies. The incidence of coronary anonalies and clinical characteristic were evaluated.
RESULTS
The incidence of coronary anomalies was 0.79% and in 28 cases of coronary anomalies, 5 cases of anomalous origin from the aorta (0.14%), 2 cases of coronary artery aneurysm (0.16%) and 21 cases of coronary arteriovenous fistula (CAVF,0.59%) were found. In 5 cases of anomalous origin from the aorta, 4 cases showed that right coronary artery originated from left coronary sinus of Valsalva, 1 case showed that left circumflex coronary artery originated from right coronary sinus of Valsalva. All of coronary artery aneurysm were found in right coronary artery. In 21 cases of CAVF, 28 sites of fistula were found and 14 sites originated from right coronary artery (50%), 6 sites from left circumflex coronary altery (21.5%), 6 sites from left anterior-descending coronary artery, 2 sites from left main coronary artery (7%). 13 sites of CAVF drained into pulmonary artery (46%), 10 sites into right atrium (36%), 5 sites into right ventricle (18%). In 7 cases which had double CAVF, 4 cases were originated from bilateral coronary artery, 3 cases were originated from single coronary artery. In 10 cases CAVF without other cardiac lesion, 4 cases confirmed ischemic heart disease.
CONCLUSION
In our study, CAVF is most common coronary anomaly and without other cardiac disease CAVF may develope ischemic cardiac disease.