Prevalence of Coronary artery anomalies detected by Coronary CT Angiography in Canton Sarajevo, Bosnia and Herzegovina.

Background: Coronary artery anomalies (CAAs) are congenital variations of one or more of the coronary arteries and they are an uncommon but important cause of chest pain and, in some cases, sudden cardiac death. Anomalies of coronary arteries may be found incidentally in 0.3-1% of healthy individuals. The three types of coronary artery anomalies are anomalies of origin, anomalies of course and anomalies of termination. The purpose of our study was to estimate the frequency of CAAs in Canton Sarajevo, B&H, and to deteremine the prevalence of origin, course and termination anomalies of coronary arteries.

Subject And Methods: This was a retrospective analysis of 919 patients who underwent Coronary CT Angiography to determine CAAs in the period from 2013 to 2017.

Results: In our study, total number of CAAs have been found among the 130 patients (14.12%) out of which anomalies of origin are found at 14 patients (1.52%), anomalies of course at 115 patients (12.5%) and anomaly of termination in 1 patient (0.1%). Out of 14 cases in total anomalies of origin, anomalies of origin of the left coronary artery are observed among 11 patients (1.2%), and anomalies of origin of the right coronary artery among 3 patients (0.3%). From mentioned 14 cases of the anomalous origin of the coronary arteries, anomalies with clinical significance (interarterial, malignant course) of the coronary arteries are found among 6 patients (0.65%) and anomalies without clinical significance are found among 8 patients (0.87%). Coronary artery anomalies of origin with malignant course are devided in two groups: LMA from right sinus of Valsalva with interarterial course observed in 4 patients (0.43%) and RCA from left sinus of Valsalva, also with interarterial course in 2 patients (0.21%). We found 4 patients (0.43%) with separated origin LAD and LCX, without LMA. The preavlence rates of separate origin of RCA and conus artery, anomaly origin of the LCX from right coronary sinus, anomaly origin of the LMA from posterior coronary sinus and LMA from right coronary sinus without interarterial course were seen in 0.1% of patients. Among 115 cases of anomalies of course 111 cases (12.07%) belongs to bridging (37 cases to LAD; 25 cases to D1 and D2 and 49 to ramus intermedius), and 4 cases (0.43%) belongs to intraatrial course of RCA. Anomaly of termination presented with fistula between LCX and coronary sinus was found only in 1 case.

Conclusion: Coronary CT angiography is an excellent tool for diagnosis of CAAs regarding origin, course and termination of the coronary arteries.