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BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access June 1, 2007

Coronary artery anomalies — a short review

David Zemanek EMAIL logo and Josef Veselka
From the journal Open Medicine

Abstract

Coronary artery anomalies are rare but sometimes important findings in the evaluation of the coronary artery. The majority of the anomalies are of benign prognosis, but others can be associated with cardiac symptoms and syndromes (angina, dyspnea, syncope, congestive heart failure, myocardial infarction and sudden death). The potentially serious anomalies include: ectopic coronary origin from the pulmonary artery; ectopic coronary origin from the opposite aortic sinus; and large coronary fistulae. Appropriate diagnosis is critical for recognition and management. Treatment can be performed by surgical or percutaneous approach. However, management is conservative in the majority of them. Contemporary diagnosis and clinical management of these anomalies are briefly reviewed and discussed in this article.

[1] P. Angelini, J.A. Velasco and S. Flamm: “Coronary anomalies: incidence, pathophysiology, clinical relevalence”, Circulation, Vol. 105, (2002), pp. 2449–2454. http://dx.doi.org/10.1161/01.CIR.0000016175.49835.5710.1161/01.CIR.0000016175.49835.57Search in Google Scholar

[2] O. Yanamaka and R.E. Hobbs: “Coronary artery anomalies in 126,595 patients undergoing coronary arteriography”, Cathet Cardiovasc. Diagn., Vol. 34, (1990), pp. 129–134. Search in Google Scholar

[3] R.W. Alexander and G.C. Griffith: “Anomalies of the coronary arteries and their clinical significance”, Circulation, Vol. 14, (1956), pp. 800–805. Search in Google Scholar

[4] A.P. Burke, A. Farb, R. Virmani, J. Goodin and J.E. Smialek: “Sports-related and non-sports-related sudden cardiac death in young adults”, Am. Heart. J., Vol. 121, (1991), pp. 568–575. http://dx.doi.org/10.1016/0002-8703(91)90727-Y10.1016/0002-8703(91)90727-YSearch in Google Scholar

[5] E.M. Tuzcu, D.S. Moodie, J.L. Chambers, P. Keyser and J.L. Hobbs: “Congenital heart diseases associated with coronary artery anomalies [see comments]”, Cleve Clin. J. Med., Vol. 57, (1990), pp. 147–152. Search in Google Scholar

[6] A.L. Taylor, K.M. Rogan and R. Virmani: “Sudden cardiac death associated with isolated congenital coronary artery anomalies”, J. Am. Coll. Cardiol., Vol. 20, (1992), pp. 640–647. http://dx.doi.org/10.1016/0735-1097(92)90019-J10.1016/0735-1097(92)90019-JSearch in Google Scholar

[7] K. Nieman, F. Cadermartiri, P. Lemos, R. Raaijmakers, R.M. Pattynama and P.J. de Feyter: “Reliable non-invasive coronary angiography with fast submilimeter multislice spiral computer tomography”, Circulation, Vol. 106, (2002), pp. 2051–2054. http://dx.doi.org/10.1161/01.CIR.0000037222.58317.3D10.1161/01.CIR.0000037222.58317.3DSearch in Google Scholar

[8] A.M. Taylor, S.A. Thorne, M.B. Rubens, P. Jhooti, J. Keegan, P.D. Gaterhouse, F. Wiesmann, F. Grothues, J. Somerville and D.J. Pennel: “Coronary artery imaging in grown up congenital heart disease: complementary role of magnetic resonance and X-ray coronary angiography”, Circulation, Vol. 101, (2000), pp. 1670–1678. Search in Google Scholar

[9] D. Zemanek, J. Veselka, D. Kautznerova and D. Tesar: “The Anomalous Origin of the Left Coronary Artery from the Right Aortic Sinus: Is the Coronary Angiography still a ‘Gold Standard’?”, Int. J. Cardiovasc. Imaging., Vol. 22, (2006), pp. 127–133. http://dx.doi.org/10.1007/s10554-005-9005-310.1007/s10554-005-9005-3Search in Google Scholar

[10] H. Serota, C.W. Barth, C.A. Seuc, M. Vandomael, F. Aquirre and M.J. Kern: “Rapid identification of the course of anomalous coronary arteries in adults: the ‘dot and eye’ method”, Am. J. Cardiol., Vol. 65, (1990), pp. 891–898. http://dx.doi.org/10.1016/0002-9149(90)91432-610.1016/0002-9149(90)91432-6Search in Google Scholar

[11] P.C. Frommelt, M.A. Frommelt, J.S. Tweddell and R.D.B. Jaquiss: “Prospective echocardiographic diagnosis and surgical repair of anomalous origin of a coronary artery from the opposite sinus with an interarterial course”, J. Am. Col. Cardiol., Vol. 42, (2003), pp. 148–154. http://dx.doi.org/10.1016/S0735-1097(03)00503-510.1016/S0735-1097(03)00503-5Search in Google Scholar

[12] J. Veselka and J. Kautzner: “Anomalous origin of the right coronary artery of pulmonary trunk: echocardiographic diagnosis?”, Echocardiography, Vol. 11, (1994), pp. 365–368. Search in Google Scholar

[13] R.L. Clic, D.R. Holmes, R.E. Vliestra, A.S. Kosinski and R.A. Kronmal: “Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival — a report from the Coronary Artery Surgery Study”, J. Am. Coll. Cardiol., Vol. 13, (1989), pp. 531–537. Search in Google Scholar

[14] E. Jokl, J.T. McClellan and G.D. Ross: “Congenital anomaly of the left coronary artery in young athletes”, JAMA, Vol. 182, (1962), pp. 572–573. Search in Google Scholar

[15] C. Basso, B.J. Maron, D. Corrado and G. Thiene: “Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leasing to sudden death in young competitive athletes”, J. Am. Col. Cardiol., Vol. 35, (2000), pp. 1493–1501. http://dx.doi.org/10.1016/S0735-1097(00)00566-010.1016/S0735-1097(00)00566-0Search in Google Scholar

[16] S. Mirchandani and C.K. Phoon: “Management of anomalous coronary arteries from the contralateral sinus”, Int. J. Cardiol., Vol. 102, (2005), pp. 383–389. http://dx.doi.org/10.1016/j.ijcard.2004.10.01010.1016/j.ijcard.2004.10.010Search in Google Scholar

[17] R.L. Romp, J.R. Herlong, C.K. Landolfo, S.P. Sanders, C.E. Miller, R.M. Ungerleider and J. Jaggers: “Outcome of unroofing procedure for repair of anomalous aortic origin of left or right coronary artery”, Ann. Thorac. Surg., Vol. 76, (2003, pp. 589–596. http://dx.doi.org/10.1016/S0003-4975(03)00436-310.1016/S0003-4975(03)00436-3Search in Google Scholar

[18] E. Erez, V.K.H. Tam, N.A. Doublin and J. Stakes: “Anomalous coronary artery with aortic origin and course between the great arteries: Improved diagnosis, anatomic findings and surgical treatment”, Ann. Thorac. Surg., Vol. 82, (2006), pp. 973–977. http://dx.doi.org/10.1016/j.athoracsur.2006.04.08910.1016/j.athoracsur.2006.04.089Search in Google Scholar

[19] J.S. Sachweh, A.R. Tiete, S. Jockenhoevel, E.G. Muhler, G. von Bernuth, B.J. Messmer and S.H. Daebritz: “Fate of intramural coronary arteries after switch operation”, J. Thorac. Cardiovasc. Surg., Vol. 30, (2002), pp. 40–44. Search in Google Scholar

[20] A.J. Doorej, M.J. Pasquale, J.F. Lally, G.S. Mintz, E. Marschall and D.A. Ramos: “Six-month success of intracoronary stenting for anomalous coronary arteries associated with myocardial ischemia”, Am. J. Cardiol., Vol. 86, (2000), pp. 580–582. http://dx.doi.org/10.1016/S0002-9149(00)01023-710.1016/S0002-9149(00)01023-7Search in Google Scholar

[21] T.P. Graham Jr, J.T. Bricker, F.W. James and W.B. Strong: “26th Bethesda conference: recommendation for determining eligibility for competition in athletes with cardiovascular abnormalities. Task Force I: congenital heart disease”, J. Am. Col. Cardiol., Vol. 24, (1994), pp. 867–873. Search in Google Scholar

[22] C.L. Backer, M.J. Stout, V.R. Zales, A.J. Muster, T.J. Weigel, F.S. Idriss and C. Mavroudis: “Anomalous origin of the left coronary artery. A twenty-year review of surgical management”, J. Thorac. Cardiovasc. Surg., Vol. 103, (1992), pp. 1049–1058. Search in Google Scholar

[23] A. Dodge-Khatami, C. Mavroudis and C.L. Backer: “Anomalous origin of the left coronary artery from the pulmonary artery: collective review of surgical therapy”, Ann. Thorac. Surg., Vol. 74, (2002), pp. 946–955. http://dx.doi.org/10.1016/S0003-4975(02)03633-010.1016/S0003-4975(02)03633-0Search in Google Scholar

[24] M.L. Schwartz, R.A. Jonas and S.D. Colan: “Anomalous origin of the left coronary artery from the pulmonary artery: recovery of the left ventricular function after dual coronary repairs”, J. Am. Coll. Cardiol., Vol. 30, (1997), pp. 547–553. http://dx.doi.org/10.1016/S0735-1097(97)00175-710.1016/S0735-1097(97)00175-7Search in Google Scholar

[25] W.C. Roberts: “Major anomalies of coronary arterial origin seen in adulthood”, Am. Heart J., Vol. 111, (1986), pp. 941–963. http://dx.doi.org/10.1016/0002-8703(86)90646-010.1016/0002-8703(86)90646-0Search in Google Scholar

[26] I.A. Williams, W.M. Gersony and W.E. Hellenbrand: “Anomalous right coronary artery arising from the pulmonary artery: A report of 7 cases and a review of the literature”, Am. Heart J., Vol. 152, (2006), p. 1004; e9-17. Search in Google Scholar

[27] J. Veselka, P. Widimsky and J. Kautzner: “Reimplantation of anomalous right coronary artery arising from the pulmonary trunk leasing to normal coronary flow reserve late after surgery”, Ann. Thorac. Surg., Vol. 76, (2003), pp. 1287–1289. http://dx.doi.org/10.1016/S0003-4975(03)00561-710.1016/S0003-4975(03)00561-7Search in Google Scholar

[28] R.N. Sing and P.C. Tailor: “Anomalous origin of the left anterior descending coronary artery from the pulmonary artery: surgical correction in adults”, Cathet Cardiovasc. Diagn., Vol. 9, (1983), pp. 1369–1371. Search in Google Scholar

[29] D.C. Levin, K.E. Fellows and H.L. Abraham: “Hemodynamic significant primary anomalies of the coronary arteries. Angiographic aspects”, Circulation, Vol. 58, (1978), pp. 25–34. Search in Google Scholar

[30] T. Carrel, T. Tkebuchava, R. Jenni R, U. Arbens and M. Turina: “Congenital coronary fistulas in children and adults: diagnosis, surgical technique and results”, Cardiology, Vol. 87, (1996), pp. 325–330. http://dx.doi.org/10.1159/00017711410.1159/000177114Search in Google Scholar

[31] G. Dorros, V. Thota, K. Ramireddy and G. Joseph: “Catheter-based technique for closure of coronary fistulae”, Cathet Cardiovasc. Interv., Vol. 46, (1999), pp. 143–150. http://dx.doi.org/10.1002/(SICI)1522-726X(199902)46:2<143::AID-CCD6>3.0.CO;2-E10.1002/(SICI)1522-726X(199902)46:2<143::AID-CCD6>3.0.CO;2-ESearch in Google Scholar

[32] S.K. Behera, S. Danon, D.S. Levi and J.W. Moore: “Transcatheter closure of coronary artery fistulae using the Amplatz duct occluder”, Cathet Cardiovasc. Interv., Vol. 68, (2006), pp. 242–248. http://dx.doi.org/10.1002/ccd.2081110.1002/ccd.20811Search in Google Scholar

[33] C.D. Liang and S.F. Ko: “Midterm outcome of percutaneous transcatheter coil occlusion of coronary artery fistula”, Pediatr. Cardiol., Vol. 27, (2006), pp. 557–563. http://dx.doi.org/10.1007/s00246-006-1317-010.1007/s00246-006-1317-0Search in Google Scholar

[34] L.R. Amrsby, J.F. Keane, M.C. Sherwood, J.M. Forbes, S.B. Perey and J.E. Lock: “Management of coronary artery fistulae”, J. Am. Coll. Cardiol., Vol. 39, (2002), pp. 1026–1032. http://dx.doi.org/10.1016/S0735-1097(02)01742-410.1016/S0735-1097(02)01742-4Search in Google Scholar

Published Online: 2007-6-1
Published in Print: 2007-6-1

© 2007 Versita Warsaw

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