PREVALENCE OF CONGENITAL CORONARY ARTERY ANOMALIES IN ADULTS PATIENTS UNDERGOING CONVENTIONAL CORONARY ANGIOGRAM-A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL IN TAMIL NADU

Abstract

Background & Objectives:Coronary artery anomalies (CAAs) are a diverse group of congenital disorders whose
manifestations and pathophysiological mechanisms are highly variable. Among patients undergoing coronary angiography,
the incidence depends on the population studied and the criteria used to define an anomaly. This study is conducted to study
the prevalence and pattern of coronary anomalies in our geographic region.
Methods:We retrospectively studied 3000 coronary angiographies (CAG) done in the institution from JANUARY2017 to
JUNE 2020 for the detection of incidence and pattern of coronary anomalies. Patients with ischemic heart disease and
valvular heart disease who underwent CAG were included in the study.
Results:Total prevalence of CAA is 2.4% as per Angelini's classification and 1.1% as per modified Angelini’s
classification. The most common anomaly was absent left main artery with separate origin of the left anterior descending
(LAD) artery and left circumflex artery (LCx) (n=18, 0.6%). Anomalous origin of LCx from right sinus/ RCA was seen in
4 patients(0.13%). Anomalous origin of the right coronary artery (RCA) from left circulation was seen in 4 patients(0.13%)
and directly from the aorta in one patient.One patient had An aberrant common trunk from the right sinus of Valsalva, with
the common trunk bifurcating into the right and left system shortly after its origin. Atretic coronary artery and origin of the
coronary artery from the pulmonary artery were not seen in our study.
Conclusion: Although CAAs are rare causes of sudden death, the anomaly of a single coronary artery, an LMCA
originating from the pulmonary artery, and congenital hypoplastic, stenotic, or atretic LMCA may lead to myocardial
infarction and sudden death.Though inthe present study we didn’t find such malignant anatomy, the total prevalence of
coronary anomalies was similar to that in other studies.