Prevalence, Variants and Presentation of Anomalous Aortostial Origin of Coronary Arteries: A Registry Based Analysis of Ten Cases.

The study was aimed at determining the prevalence, different patterns of origin of coronary arteries and their clinical presentation in patients who underwent coronary angiography. In this cross-sectional study, initially 2000 patients who underwent coronary angiogram (CAG) for chronic stable angina or acute coronary syndrome or required CAG as pre-operative evaluation for other surgery in the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from July 2019 to December 2020 were enrolled after taking informed consent. The prevalence of anomalous aorto ostial origin among 2000 study population was 0.5%. Among 10 patients, males were predominant 8(80.0%) with a mean age of 51.0±3.0 years. The coronary artery anomalies were more common in the right coronary artery (RCA) than the left coronary artery. Out of 10 patients, RCA arouse from the left coronary sinus (3) and the separate origin of left anterior descending and left circumflex artery (3) were equal. The next common anomaly was the left coronary artery arising from the right coronary sinus (2) followed by the left circumflex artery arising from the right coronary sinus (1) and double right coronary artery (1). Twenty percent (20.0%) of the patients were asymptomatic and diagnosed during coronary angiogram for other surgery. Thirty percent (30.0%) of the cases presented with chronic stable angina and 50.0% of the total cases presented with acute coronary syndrome. Anomalous origin of coronary arteries may present as an isolated defect or as a part of complex congenital heart disease. Presentation and prognosis varies widely from asymptomatic to sudden cardiac death according to the type of various anomalies. So, congenital coronary artery anomalies pattern should be sorted out for risk stratification and proper management.