Anomalous Circumflex Coronary Artery Research Articles

Delayed Presentation of Anomalous Circumflex Coronary Artery Arising From Pulmonary Artery Following Repair of Aortopulmonary Window in Infancy

Anomalous origin of the circumflex coronary artery is extremely rare and may cause serious perioperative myocardial injury associated with correction of coexisting congenital malformations. We describe a 15-year-old female patient who underwent surgical correction of an aortopulmonary window at 13 months. Fourteen years later, she presented with dyspnea on exertion associated with angina. On cardiac catheterization, she was noted to have a step-up in oxygen saturation in the pulmonary artery and retrograde filling of the circumflex coronary artery from the left anterior descending coronary artery, with drainage into the pulmonary artery. The patient underwent surgical bypass of the anomalous circumflex coronary artery and ligation of its anomalous origin in the pulmonary artery. Her postoperative course was uneventful, with complete relief of symptoms. We have reviewed this rare congenital anomaly and its therapeutic options.

Proximal bypass to anomalous circumflex coronary artery

A technique for coronary artery bypass to the proximal segment of an anomalous circumflex coronary artery is described. This technique has been used in four patients. It is suggested that in some situations this would be the preferable approach for bypassing an anomalous circumflex coronary artery obstruction.

Thallium-201 myocardial imaging in patients with angina pectoris and anomalous aortic origin of the circumflex coronary artery

Anomalous aortic origin of the circumflex coronary artery is the commonest coronary artery anomaly. In this study, the significance of anomalous aortic origin of the circumflex coronary artery was investigated in seven patients with exertional chest pain using exercise thallium scintigraphy. Five patients with circumflex coronary arterial disease served as controls. Myocardial perfusion was normal in the five patients with a nonstenosed anomalous artery. In these patients, exercise heart rate and blood pressure response were normal. Two patients with a stenosed anomalous circumflex coronary artery and four of the five control patients had posterolateral myocardial perfusion defects. It is concluded that anomalous aortic origin of the circumflex coronary artery does not cause impairment of myocardial perfusion unless it is the site of significant coronary arterial stenosis.

Anomalous origin of the left circumflex coronary artery. Recognition, antiographic demonstration and clinical significance.

Anomalous origin of the circumflex coronary artery from the proximal right coronary artery or right sinus of Valsalva was recognized in 20 of 2996 patients undergoing selective coronary arteriography (0.67%). The relative frequency of this anomaly demands a high level of anticipation during the performance of selective coronary arteriography to assure that an adequate study has been obtained. Failure to recognize and properly demonstrate the anomaly can be hazardous to patient management. Two angiographic signs have proved reliable in recognizing the anomalous artery before its selective demonstration. These signs are a profile view of the artery behind the aortic root during left ventriculography (the "aortic root sign") and recognition of absent arterial inflow to a significant area of the posterior lateral left ventricle during selective injections of the main left coronary artery (the "sign of non-perfused myocardium"). These angiographic signs are described and the clinical implications of proper demonstration of the anomalous circumflex coronary artery are discussed.