The Prevalence of Coronary Artery Anomalies in Children with Congenital Heart Disease

Abstract

Background and purposes: Coronary artery anomalies (CAA), although rare in the general population, are common in patients with congenital heart disease (CHD). CAA can be the cause of sudden cardiac death; thus, the childhood diagnosis of CAA is essential in patients suffering from CHD. The present study aimed to investigate the prevalence of CAAs in pediatric patients with CHD in Iran. Materials and Methods: We recruited children with CHD (one day to 21 years old), who were referred to the CT Department of Shahid Rajaei Hospital (Tehran, Iran) to undergo CT angiography (CTA) for various reasons between 2011 and 2013. We recorded age, gender, and underlying heart diseases, as well as the CTA findings, reported by a radiologist and a cardiologist. We classified CAAs using the most commonly used classification of CAA based on anatomical considerations. Results: Among a total of 219 patients with CHD, 112 (51.1%) were male, and 107 (48.9%) were female with the mean age of 3.5 ± 2.4 years. The prevalence of CAAs was 8.7% (19 patients) with no significant difference based on gender (P-value >0.05). All 19 patients had CAAs of origin; the most common CAAs were anomalous origin of right coronary artery (RCA) from left sinus (31.6%) and anomalous origin of left main coronary artery (LMCA) from pulmonary artery (ALCAPA) (21.0%), respectively. Conclusion: We observed a high prevalence of CAA in children with CHD, which emphasizes the importance of raising awareness about CAAs and improving the screening methods in the pediatric population suffering from CHD.