The Incidence and Pattern of Coronary Artery Anomalies in the North-West of Iran: A Coronary Arteriographic Study

Background and Objectives: Coronary artery anomalies are found in approximately 1% of patients undergoing diagnostic coronary angiography (CAG). Angiographic recognition of these vessels is important because of their clinical significance and importance in patients undergoing coronary angioplasty or cardiac surgery. There are fairly enough reports concerning the incidence of coronary anomalies in different geographic areas, but this is the first study among the Iranian population. Subjects and Methods: We reviewed the database of the Catheterization Laboratory of Imam Reza and Shahid Madani Hospitals, Tabriz University of Medical Sciences, Iran. Our inquiry included all patients who referred for CAG from other hospitals, between February 2007 and April 2009. Patients with congenital heart diseases, high "take off" of coronary arteries and separate origin of the conus artery from the right coronary sinus (RCS) were excluded. In total, 6065 films were reviewed. Results: Seventy nine (1.30%) patients were found to have coronary anomalies. Seventy five (1.24%) patients had anomalies of origin and distribution, while four (0.06%) had coronary artery fistulae. Most common anomaly was separate ostia of the left anterior descending artery and left circumflex artery, which was found in 42 patients (53.16%) with angiographic incidence of 0.69%. The next most common anomalies were anomalous circumflex artery from RCS/right coronary artery (RCA) {n=17 (21.51%)}, and anomalous RCA arising from left coronary sinus {n=6 (7.59%)}. Conclusion: In general, the incidence and pattern of coronary anomalies in our study was similar to earlier reports from different parts of the world.