ANOMALOUS RIGHT OR LEFT CORONARY-ARTERY FROM THE CONTRALATERAL CORONARY SINUS - HIGH-RISK ABNORMALITIES IN THE INITIAL CORONARY-ARTERY COURSE AND HETEROGENEOUS CLINICAL OUTCOMES

Coronary artery anomalies are associated with sudden cardiac death, al though individual patient outcomes are highly variable. We performed b linded pathologic analysis of 30 consecutive cases of anomalous right (n = 21) or left (n = 9) coronary artery from the contralateral corona ry sinus to determine which, if any, features might aid in risk strati fication for sudden cardiac death. We found no significant differences in length of aortic intramural segment, coronary ostial size, degree of displacement of the anomalous coronary artery from the correct coro nary sinus, or angle of coronary takeoff between patients with (n = 12 ) and without (n = 18) sudden cardiac death. All pathologic features s howed considerable interpatient variability. Age greater than or equal to 30 years was the only variable associated with a decreased inciden ce of sudden cardiac death. Thus no simple relation exists between var iations in the initial coronary artery course and clinical outcome in these anomalies.