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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA)
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Coronary Artery Origin Anomalies on Coronary CT Angiography: A Single-Center Tertiary-Care Cohort

Nur Betül Karatoprak1, Sinan Karatoprak1, Ömer Şahin2

  • 1Department of Radiology, Kayseri City Training and Research Hospital, Kayseri, Türkiye.

Journal of Clinical Practice and Research
|June 17, 2026
PubMed

Insights

Coronary CT angiography revealed that 1.29% of patients have coronary artery origin anomalies. This study details the prevalence and proximal course characteristics of these congenital coronary variants.

Area of Science:

  • Cardiovascular Imaging
  • Radiology
  • Anatomy

Background:

  • Congenital coronary artery anomalies are rare but can have significant clinical implications.
  • Accurate identification of these anomalies is crucial for patient management and risk stratification.

Purpose of the Study:

  • To determine the prevalence of coronary artery origin anomalies using coronary CT angiography (CCTA).
  • To describe the specific characteristics of the proximal course of these anomalies.

Main Methods:

  • Retrospective analysis of 3,181 consecutive CCTA examinations.
  • Scans acquired using a 64-slice multidetector CT system with ECG gating.
  • Anomalies classified using the Angelini framework; proximal course categorized.

Main Results:

  • Prevalence of coronary artery origin anomalies was 1.29% (41/3,181 patients).
  • Opposite-sinus origin was the most common anomaly (0.76%), followed by absent LMCA (0.16%) and single coronary artery (0.09%).
  • Interarterial course was observed in 20 patients, retroaortic in 10, and prepulmonic in 2.

Conclusions:

  • CCTA is effective in delineating coronary ostial origin and proximal trajectory.
  • This imaging modality supports comprehensive anatomic assessment of congenital coronary variants.
Abstract

Keywords:
Computerized tomographycongenital anomaliescoronary angiographycoronary vessel anomaliescoronary vessels

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