الفهرس | Only 14 pages are availabe for public view |
Abstract Coronary artery anomalies are uncommon congenital conditions with incidence ranging from 0.17% in autopsy cases 1 to 1.2% in cases evaluated through conventional angiography. Most of these anomalous conditions are clinically asympomatic. However, severe chest pain or sudden death can occur in such patients, most notably among young athletes or after vigorous exercise. If the aberrant vessel traverses in between the aorta and the main pulmonary artery, it can cause sudden death, especially if the aberrant vessel supplies the left coronary artery distribution. (105) The anatomic variations and anomalies of coronary arteries, i.e. the origin and course of coronary arteries as well as their branches and territories, were identified in all patients. Variants were considered in term of coronary dominance (right, left and co-dominance), origin of the conus artery and the sinoatrial node artery (SNA), and the presence of ramus intermedius. Coronary artery anomalies were classified according to the classification system developed by Angelini et al. as anomalies of origination and course, anomalies of intrinsic coronary arterial anatomy, and anomalies of coronary termination. The coronary segments were classified according to the American Heart Association scheme. (10) The purpose of this study was to evaluate the prevalence of coronary artery anomalies in patients performing multi-detector CT coronary angiography by using 256 and 320 slices machines. In our study out of 2000 patients referred to MDCT coronary angiography, 357 patients had anomalies coronary artery, The Myocardial bridging was the most frequent anomaly reaching 248 (12.5%) patients of the entire study group, single coronary artery in 0.8% of patients, high take off in 0.8%, ALCAPA in 0.7% of the cases and fistula in (0.5%) and duplicated LAD in (0.8%). Our study showed that the incidence of these variations and anomalies in our population is close to that reported in other populations and that coronary artery anatomical variations are almost benign entities with no haemodynamic significance, while some congenital anomalies may interfere with adequate myocardial blood supply causing variable ischemic symptoms. |