The prevalence of coronary artery anomalies on CT scan - Experience from a tertiary care center in Pakistan (RCD code: I-1C.1)

Objectives: This study is an effort to bridge the gap regarding the data of prevalence of coronary anomalies in South Asian countries by utilizing coronary computed tomography angiography (CCTA). Methods: This is a cross sectional, descriptive study done at Aga Khan University Hospital Karachi, Pakistan. All adult patients who underwent CCTA from 1-1-2005 to 1-11-2016 were included in the study. Results: Among 897 patients undergoing CCTA, 36 (4.01%) patients were identified as having coronary artery anomalies (CAA). The mean age of patients was 48.3±11.9 years. Male to female ratio was 3:1. Among patients with CAA, the most common indication for CCTA was screening for coronary artery disease (58.3%). 33 patients (3.67%) showed coronary origin and course anomalies, whereas coronary artery fistulas were identified in 3 patients (0.3%). The most common anomaly identified was the anomalous origin of coronary artery from the opposite coronary sinus with anomalous course (1.4%) with anomalous origin of right coronary artery from the left coronary sinus with an inter-arterial course seen in 9 patients. Single coronary artery was seen in three cases (0.3%), in all these cases the single coronary artery originated from the right coronary cusp. In one patient (0.1%) dual left anterior descending (LAD) system was identified. In two cases (0.2%) fistulous connection of LAD with pulmonary artery was seen, while fistula from LAD to coronary sinus was identified in one patient. Conclusions: This study highlights the fact that the prevalence of coronary anomalies on CCTA in this region is similar to the data reported from the rest of the world.