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[Coronary vessel anomalies in adults--harmless variation or changes with clinical significance]
Insights
Coronary artery anomalies, including fistulas and aneurysms, were found in a review of coronary angiograms. Further research is needed to understand the clinical significance of these variations and malformations.
Area of Science:
- Cardiology
- Vascular Surgery
- Medical Imaging
Background:
- Coronary artery anomalies are variations or malformations of the coronary arteries.
- Their clinical significance can range from asymptomatic findings to severe conditions.
Purpose of the Study:
- To evaluate the incidence and clinical significance of coronary artery anomalies.
- To assess the role of coronary angiography in identifying these anomalies.
Main Methods:
- Review of 1097 consecutive coronary angiograms.
- Analysis of identified coronary artery anomalies: arteriovenous fistulas, malpositions, aneurysms, and myocardial bridging.
Main Results:
- Incidence rates: arteriovenous fistulas (0.25%), malpositions (0.55%), aneurysms (2.65%), and myocardial bridging (5.4%).
- Identified malformations include Bland-White-Garland syndrome, arteriovenous fistulas, congenital coronary stenosis, and atresia.
- Myocardial bridging remains controversial regarding its clinical significance.
Conclusions:
- Coronary angiography can detect various coronary artery anomalies.
- Surgical correction should be considered for symptomatic malformations.
- Further clinical investigations are necessary to fully understand coronary artery anomalies and their implications.
Abstract:
A review of 1097 consecutive coronary angiograms performed for evaluation of angina pectoris or valvular dysfunctions showed 3 patients with arteriovenous fistulas (0.25%), 6 patients with malpositions (0.55%), 29 patients with aneurysms (2.65%) and 59 patients with myocardial bridging (5.4%). The clinical significance of coronary artery anomalies as variation or malformation was evaluated. A malformation has been found in Bland-White-Garland syndrome, arteriovenous fistulas, congenital coronary stenosis and atresia. In case of clinical symptoms surgical correction should be considered. There is a controversy on the clinical significance of muscular bridging. Further clinical investigations are needed for a better understanding of coronary artery anomalies.