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The clinical anatomy of high take-off coronary arteries

Marios Loukas1, Rebecca G Andall1, Akbar Z Khan1

  • 1Department of Anatomical Sciences, St. George's University, School of Medicine Grenada, West Indies.

Clinical Anatomy (New York, N.Y.)
|November 1, 2015
PubMed

Insights

High take-off coronary arteries, originating above the sinotubular junction, occur in 0.202% of individuals. Anatomical variations and clinical implications, particularly sudden cardiac death association, warrant careful diagnosis.

Area of Science:

  • Cardiovascular Anatomy
  • Medical Imaging
  • Clinical Cardiology

Background:

  • High take-off coronary arteries (HTCA) are anatomically defined as coronary arteries originating superior to the sinotubular junction.
  • Varied definitions in literature contribute to uncertainty regarding their pathological significance.
  • HTCA may present clinical implications during cardiac procedures.

Purpose of the Study:

  • To review anatomical variations of HTCA.
  • To highlight potential clinical implications of HTCA during angiography and surgery.
  • To analyze the association between HTCA and adverse cardiac events.

Main Methods:

  • Comprehensive English literature search for studies on HTCA.
  • Meta-analysis included HTCA defined as originating ≥1 cm (adults) or 20% sinus depth (children) above the sinotubular junction.
  • Exclusion of case studies and case reviews.

Main Results:

  • Prevalence of HTCA was 0.202% (26/12,899 individuals).
  • HTCA originated up to 5 cm above the sinotubular junction, with right coronary arteries being most common (84.46%).
  • Three cases (0.023%) with HTCA >1 cm above the sinotubular junction were linked to sudden cardiac death.

Conclusions:

  • HTCA, especially those originating significantly above the sinotubular junction, have a notable association with sudden cardiac death.
  • Accurate diagnosis of HTCA is crucial for managing patients with cardiac comorbidities.
  • Understanding HTCA variations is vital for interventional cardiologists and surgeons.

Keywords:
anomalies of aortic origincoronary arterial anomaliessudden cardiac death

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