CORONARY ARTERY ANOMALIES;

Congenital anomalies of the coronary arteries occur in 0.2% to 1.2% of the generalpopulation . The incidence of various coronary anomalies and associated clinical, angiographic and hemodynamic 1findings have been cited in several internationally published clinical series . To compare our experience with 4-8previously reported studies, we have reviewed clinical and angiographic findings for 50 adult patients with coronaryartery anomalies. Patients and Methods: We surveyed the records of 5050 consecutive adult patients who hadundergone coronary angiography.Setting: Armed Forces Institute of Cardiology and National Institute of Heart Disease(AFIC/NIHD) Rawalpindi. Period: 1 Jan 2004 and 30 April 2005, and identified 50 adults with various coronary artery st thanomalies. Results: 5050 reports were reviewed and 50 (0.9%) coronary artery anomalies were identified in 50patients. Different anomalies identified are; both coronary arteries from right sinus of Valsalva (RSV)-(n = 1), bothcoronary arteries arising from the left coronary sinus (n = 4), single coronary arteries (n = 2), LCx from RSV/RCA (n=6),anterior descending artery arising from the right coronary sinus (n = 1), coronary artery fistulae (n = 4), separated originof anterior descending and left circumflex coronary arteries (n = 25), and separate origin of conus/ RV branch (n = 7).The initial course was retroaortic in all the circumflex arteries, interarterial in the right coronaries, and anterior in theanterior descending arteries. Conclusions: We conclude that adult congenital anomalies of the coronary arteries arenot uncommon finding in a tertiary care cardiac center. Separate origin of LAD and LCx from LSV and left circumflexcoronary artery arising from RSV/RCA are the most frequently diagnosed anomalies.