Muhammad Qaiser Khan, Masudul Hassan Nuri, Muhammad Irfan, Afsar Raza, Shahid Abbas.
Coronary artery anomalies; an AFIC/NIHD experience.
Professional Med J Jan ;15(2):247-54.

Congenital anomalies of the coronary arteries occur in 0.2% to 1.2% of the general population`. The incidence of various coronary anomalies and associated clinical, angiographic and hemodynamic findings have been cited in several internationally published clinical series". To compare our experience with previously reported studies, we have reviewed clinical and angiographic findings for 50 adult patients with coronary artery anomalies. Patients and Methods: We surveyed the records of 5050 consecutive adult patients who had undergone coronary angiography. Setting: Armed Forces Institute of Cardiology (AFIC) Rawalpindi. Period:1st` Jan 2004 and 30th` April 2005, and identified 50 adults with various coronary artery anomalies. Results: 5050 reports were reviewed and 50 (0.9%) coronary artery anomalies were identified in 50 patients. Different anomalies identified are; both coronary arteries from right sinus of Valsalva (RSV)-(n = 1), both coronary arteries arising from the left coronary sinus (n = 4), single coronary arteries (n = 2), LCx from RSV/RCA (n=6), anterior descending artery arising from the right coronary sinus (n = 1), coronary artery fistulae (n = 4), separated origin of anterior descending and left circumflex coronary arteries (n = 25), and separate origin of conus/ RV branch (n = 7). The initial course was retroaortic in all the circumflex arteries, interarterial in the right coronaries, and anterior in the anterior descending arteries. Conclusions: We conclude that adult congenital anomalies of the coronary arteries are not uncommon finding in a tertiary care cardiac center. Separate origin of LAD and LCx from LSV and left circumflex coronary artery arising from RSV/RCA are the most frequently diagnosed anomalies.

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