CORONARY ANOMALIES - INCIDENCE AND IMPORTANCE

Most patients with coronary anomalies are asymptomatic. The knowledge of those variations could be important in regard to invasive catheter treatment or bypass surgery. In a retrospective study, the angiographi c findings based on 4,016 patients (1985-1989) were analyzed concernin g coronary anomalies and malformations. Of the patients studied, 39 (0 .97%) had coronary anomalies, and in 26 of these patients it was an an omalous circumflex branch. In 14 cases, the circumflex branch arose fr om a separate origin in the left aortic sinus. In 11 patients the orig in was from the proximal segment of the right coronary artery. A singu lar coronary artery was found in five patients, originating from the r ight aortic sinus in two patients and from the left aortic sinus in th ree patients. An origin of the left coronary artery from the pulmonary artery, a coronary fistula, or an origin of the left anterior descend ing coronary artery from the RCA could be found in only one patient. U nexpected findings during invasive procedures would suggest a possibly existing coronary anomaly, especially when main branches cannot be op acified by selective contrast medium injection.