Anomalous aortic origin of a coronary artery in 16,680 patients evaluated by cardiac computed tomography.

Purpose: Anomalous aortic origin of a coronary artery (AAOCA) is a congenital cardiac anomaly in which a coronary artery arises from an abnormal location on the aorta. In this article, we refer to the classification by Cheezum Methods: We retrospectively analyzed 16,680 electrocardiography-gated cardiac computed tomography (CT) scans from years 2015-2022. Anomalies were found in 102 patients. Inclusion criteria were: scan description allowing for identification of coronary anomalies or images available, and patient age over 18 years. This resulted in a sample of 96 patients with anomalies. Results: The study group consisted of 42 women and 54 men; median age at the time of diagnosis was 61 years. The most common anomalies were: right anomalous origin of the left circumflex artery (R-LCx) (48 cases - 50%), right coronary artery from the left sinus (17 cases - 18%), left main coronary artery from the right sinus (7 cases - 7%), and left anterior descending artery from the right sinus (12 cases - 13%). The courses were as follows: retroaortic (47 cases - 48%), interarterial (27 cases - 29%), retrocardiac (2 cases - 2%), and prepulmonic (2 cases - 2%). Conclusions: AAOCAs were found in 0.58% of CT scans performed. R-LCx was the most prevalent type, and the most prevalent course was retroaortic (47). Anomalies were mostly benign in their clinical manifestations.