Prevalence and spectrum of coronary artery anomalies detected on coronary CT angiography.

Purpose: Adult coronary artery congenital anomalies prevalence ranges between 1% and 5.6% in general population. Although many of these anomalies are benign, asymptomatic, and discovered incidentally, some of them can be associated with serious cardiovascular events that may lead to sudden cardiac death. Coronary CT angiography (CCTA) is noninvasive imaging modality that can reliably detect these anomalies. The aim of our study is to study the prevalence and spectrum of coronary arteries congenital anomalies in patients referred to CCTA. Patients and methods: This study is retrospective medical record review. Between August 2015 and June 2023, 1556 patients underwent CCTA at King Abdullah University Hospital. Seven patients with deficient medical records were excluded from the study. Of the 1549 patients included in the study, 52.6% were males. Mean age of the study objects was 51 years. The electronic medical records and images findings were reviewed for the indication for the study and presence of coronary anomalies. Results: The prevalence of coronary artery anomalies in our study population was 2.13% (excluding the myocardial bridging) and 4.84% (including the myocardial bridging). Nineteen patients had anomalous RCA originating from the left aortic sinus with inter-arterial course (1.23%), four cases of anomalous LCX artery with retro-aortic course (0.26%). Seven patients with anomalous LCA (0.45%) have three distinct types: Four patients with LCA arising from non-coronary cusp with retro-aortic course, two patients with LCA arising from right sinus with inter-arterial course, one patient with LCA arising from right coronary sinus with retro-aortic course. One patient with LAD arising from right coronary sinus with inter-arterial course (0.06%). One patient with pulmonary origin of LCA artery (0.06%), one patient with termination of arteriovenous fistula (0.06%). Forty-two patients had myocardial bridging (2.71%). Conclusion: The prevalence and spectrum of congenital coronary artery anomalies in Jordan is similar to the world population. CCTA is reliable noninvasive imaging modality in detection of such anomalies and determine their possible serious clinical association.