Research article

Primary congenital anomalies of the coronary arteries and relation to atherosclerosis: an angiographic study in Lebanon

Ali H Eid¹ , Ziad Itani² , Mohammad Al-Tannir² , Said Sayegh² and Ali Samaha^2,3,4

¹  Department of Biology, College of Science, United Arab Emirates University, Al-Ain, UAE

²  Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon

³  Department of Human Morphology, Faculty of Public Health, Lebanese University, Zahle, Lebanon

⁴  Cellular and Molecular Signaling Research Group, Departments of Biology and Biomedical Sciences, Faculty of Arts and Sciences, Lebanese International University, Beirut, Lebanon

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Journal of Cardiothoracic Surgery 2009, 4:58doi:10.1186/1749-8090-4-58

Published:	29 October 2009

Abstract

Background

Most coronary artery anomalies are congenital in origin. This study angiographically determined the prevalence of different forms of anomalous aortic origins of coronary anomalies and their anatomic variation in a selected adult Lebanese population. Correlation between these anomalies and stenotic coronary atherosclerotic disease was also investigated.

Methods

4650 coronary angiographies were analyzed for anomalous aortic origin. These anomalies were clustered in four main groups: anomalous left circumflex (LCX) coronary artery, anomalous right coronary artery, anomalous left main coronary artery and anomalous left anterior descending coronary artery.

Results

Thirty four patients had anomalous aortic origin of coronary arteries. Of these, anomalous LCX coronary artery was the most common (19 of 34 patients). The second most common anomaly was anomalous RCA origin (9 of 34 patients.) The incidence of coronary stenosis in non-anomalous vessels was 50%. However, a significantly smaller percentage (17.46%; 6 of 34 patients) of anomalous vessels exhibited significant stenosis, reminiscent of atherosclerotic disease. Of these six vessels, five were LCX coronary artery arising from right coronary sinus or from early branch of right coronary artery. The sixth was right coronary artery arising from left coronary sinus.

Conclusion

The incidence of congenital coronary anomalies in Lebanon is similar to other populations where the most common is the LCX coronary artery. Isolated congenital coronary anomalies do not increase the risk of developing coronary stenosis or atherosclerosis. Angiographic detection of these anomalies is clinically important for coronary angioplasty or cardiac surgery.