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Surgical treatment of coronary artery anomalies

M Yacoub1, J Pepper

  • 1National Heart and Lung Institute, London, UK.

Insights

This review covers coronary artery anomalies, including abnormal origins, fistulas, and those associated with congenital heart defects. It details normal coronary anatomy and physiology for context.

Area of Science:

  • Cardiovascular Anatomy
  • Congenital Heart Disease
  • Medical Imaging

Background:

  • The proximal coronary arteries are crucial for myocardial perfusion.
  • Congenital anomalies of the coronary arteries can lead to significant cardiovascular pathology.
  • Understanding normal anatomy is essential for diagnosing coronary artery abnormalities.

Purpose of the Study:

  • To review the literature on coronary artery anomalies published between June 1990 and May 1991.
  • To provide a comprehensive overview of various coronary artery anomalies.
  • To discuss the clinical significance and associations of these anomalies.

Main Methods:

  • Literature review of scientific papers.
  • Synthesis of information on normal coronary anatomy and physiology.
  • Categorization and discussion of different types of coronary anomalies.

Main Results:

  • Detailed description of normal proximal coronary artery anatomy and physiology.
  • Identification and discussion of anomalous origin of coronary arteries from the aortic sinus.
  • Review of anomalous origin of the left coronary artery from the pulmonary artery.
  • Exploration of coronary arteriovenous fistulas.
  • Analysis of coronary anomalies in specific congenital heart conditions, including left-sided heart syndrome and pulmonary atresia with intact interventricular septum.
  • Examination of coronary arterial abnormalities in transposition of the great arteries.
  • Discussion of iatrogenic coronary anomalies.

Conclusions:

  • Coronary artery anomalies encompass a wide spectrum of conditions.
  • Accurate diagnosis and understanding of these anomalies are vital for patient management.
  • Coronary anomalies can occur in isolation or in association with complex congenital heart disease.

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