Right Coronary Artery Originating from the Left: Do Not Miss the Diagnosis!
Sedat Türkoğlu1, Serkan Ünlü1, Gülten Aydoğdu Taçoy1
1Department of Cardiology, Gazi University School of Medicine, Ankara, Turkey.
Insights
The most frequent anomalous origination of a coronary artery from the opposite sinus (ACAOS) is the right coronary artery (RCA) originating from the left coronary sinus (LCS). This finding highlights potential underreporting of this specific coronary anomaly.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Congenital Heart Disease
Background:
- Anomalous origination of a coronary artery from the opposite sinus (ACAOS) is a congenital heart defect with varying reported prevalences.
- The left circumflex (LCx) artery originating from the right coronary artery (RCA) system is often cited as the most common ACAOS type.
- Contradictory findings suggest the right coronary artery (RCA) originating from the left coronary sinus (LCS) may be more frequent.
Purpose of the Study:
- To determine the most common type of ACAOS within a single-center registry.
- To clarify the prevalence of different ACAOS variations.
Main Methods:
- Retrospective analysis of a catheterization laboratory database.
- Inclusion of all coronary angiograms performed between 1999 and 2006.
- Detailed review of all examinations to identify and classify ACAOS cases.
Main Results:
- ACAOS was identified in 35 out of 5165 coronary angiograms.
- The most frequent ACAOS type was the right coronary artery (RCA) originating from the left coronary sinus (LCS) (16 cases).
- The left circumflex artery (LCx) originating from the right coronary sinus (RCS) or RCA occurred in 13 cases.
- Five cases of RCA originating from LCS were previously misdiagnosed or unreported.
Conclusions:
- Right coronary artery (RCA) originating from the left coronary sinus (LCS) is the most common ACAOS in this registry.
- Potential for misdiagnosis and underreporting of RCA originating from LCS may influence true prevalence data.
- Accurate identification of ACAOS is crucial for understanding its epidemiology.
Objective:
Left circumflex (LCx) artery originating from the right coronary arterial (RCA) system has been reported as the most common form of anomalous origination of a coronary artery from the opposite sinus (ACAOS). However, some studies claim that RCA originating from the left coronary sinus (LCS) is the most frequent form. The aim of this study was to determine the most common type of ACAOS in a single center.
Materials And Methods:
The database of the catheterization laboratory was retrospectively searched. All patients who were performed coronary angiography between 1999 and 2006 were included to registry. All examinations were carefully analyzed to determine the most frequent type of ACAOS.
Results:
We detected ACAOS in 35 cases (16 RCA originating from the LCS, 13 LCx from the RCS or the RCA, and 6 others) out of 5165 coronary angiograms. The most common form was RCA originating from LCS. Moreover, we revealed that 5 cases with RCA originating from the LCS were previously misdiagnosed and not reported as a coronary anomaly.
Conclusions:
RCA originating from the LCS was the most common form of ACAOS in our registry. The high change of misdiagnosis or underreporting of this anomaly could have biased the true prevalence.
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