The incidence of congenital coronary artery anomalies in the Southeast Anatolia Region

Objectives: We retrospectively reviewed patients who underwent routine coronary angiography in our catheterization laboratory in order to determine the incidence of congenital coronary artery anomalies in the Southeast Anatolia Region of Turkey. Study design: Catheterization reports of 5,018 patients who underwent coronary angiography from January 1998 to April 2005 were reviewed. Cineangiographies and records of patients in whom anomalous coronary arteries were detected were further analyzed. The anomalies were evaluated according to the recommendations of Serota et al. Patients were classified according to the origin of the anomalous coronary artery and accompanying coronary artery stenosis of greater than 50%. Results: Congenital coronary artery anomalies were documented in 19 patients (0.4%; 13 men, 6 women; mean age 48.2 years; range 32 to 74 years). The most frequent anomaly was that of the left circumflex artery in 11 patients (57.9%), all of which originated from the right coronary sinus. Six patients (31.6%) had an anomalous right coronary artery originating from the left coronary sinus. In two patients (10.5%), the left anterior descending and the left circumflex arteries originated from the right coronary sinus with separate ostia. Ten patients (52.6%) were found to have coronary artery disease including single-, two-, and three-vessel disease in seven patients (36.8%), two patients (10.5%), and one patient (5.3%), respectively. Atherosclerosis was present in the anomalous coronary artery in eight patients (42.1%). Conclusion: The incidence of congenital coronary artery anomalies shows geographical variations in individual populations. In our population, it is slightly lower than those reported in the literature. For appropriate and complete treatment, congenital coronary artery anomalies should be identified with their origin and course.