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 CT angiography. Methods This is a cross sectional, descriptive study done at Aga Khan University Hospital Karachi, Pakistan. All adult patients who underwent coronary CT angiography 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 coronary anomalies, 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 fistula were identified in 3 patients(0.3% of cases). The most common anomaly identified was the anomalous origin of coronary artery from opposite coronary sinus with anomalous course(1.4%) with anomalous origin of RCA 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 LAD system was identified. Coronary artery fistulas were seen in 3 patients (0.3%).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 reported data from rest of the world.