Abstract
Background and Aim: Congenital coronary artery anomalies (CCAA) represent a relatively rare heterogeneous group of congenital disorder. They are increasingly recognized due to the improvement of non-invasive imaging techniques. Continuous and profound changes are taking place regarding prevalence, definition, classification, risk of SCD, diagnostic and treatment of those anomalies. Methods: We retrospective reviewed our experience (from 2008 to 2017) in 21 patients with CCAA, which were classified as coronary artery arising from the contralateral sinus of Valsalva with intramural or interarterial course (9), coronary artery arising from the pulmonary artery (6), single ostium (1), coronary arteriovenous fistula (2), and myocardial bridges (3). 76% of patients were younger than 30 years of age with a M:F ratio of 1.6:1. The anatomic features, diagnostic and operative techniques for each defect were evaluated. Results: Anomalous origins from the wrong sinus (AOWS) was the most common anomaly (42,8%). No operative procedures were associated with early or late mortality in all the categories. During follow-up most patients were asymptomatic with good results at follow-up imaging. Conclusions: Spectrum of CCAA subtypes has changed, among our patients AOWS was the most common anomaly. Based on our experience, early diagnosis and surgical intervention can yield satisfactory results in patients with CCAA, with most experiencing relief of symptoms.
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