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Incidence and clinical relevance of primary congenital anomalies of the coronary arteries in children and adults

Published online by Cambridge University Press:  20 July 2012

Giulia Tuo ,
Maurizio Marasini ,
Claudio Brunelli ,
Lucio Zannini  and
Manrico Balbi
Giulia Tuo*
Affiliation:
Department of Paediatric Cardiology and Cardiac Surgery, Giannina Gaslini Institute, Genova, Italy
Maurizio Marasini
Affiliation:
Department of Paediatric Cardiology and Cardiac Surgery, Giannina Gaslini Institute, Genova, Italy
Claudio Brunelli
Affiliation:
Department of Cardiology, University of Genova, San Martino Hospital, Genova, Italy
Lucio Zannini
Affiliation:
Department of Paediatric Cardiology and Cardiac Surgery, Giannina Gaslini Institute, Genova, Italy
Manrico Balbi
Affiliation:
Department of Cardiology, University of Genova, San Martino Hospital, Genova, Italy
*
Correspondence to: Dr G. Tuo, MD, Department of Paediatric Cardiology and Cardiac Surgery, Giannina Gaslini Institute, Viale Pio VII 18/4, 16148 Genova, Italy. Tel: +390105636250; Fax: +39010386804; E-mail: gtuo@libero.it
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Abstract

Objectives

To describe our experience in the management of coronary artery anomalies both in an adult and in a paediatric population and to compare the two groups for finding out differences in terms of angiographic incidence and treatment.

Patients and methods

Databases at the Department of Cardiology of San Martino Adult's Hospital and of Gaslini Children's Hospital were searched for all patients with a diagnosis of coronary artery anomaly who underwent coronary angiography between 1994 and 2006.

Results

Coronary anomalies were diagnosed in 76 (1%) adult patients. Anomalous left circumflex artery was the commonest coronary anomaly (25%). Anomalous left coronary artery from pulmonary artery and myocardial bridges were the only anomalies responsible for angina-like symptoms. No patients except the one with anomalous left coronary artery from pulmonary artery needed surgical intervention. In the paediatric population, we found 28 (0.9%) patients with coronary anomalies. Anomalous left coronary artery from pulmonary artery was the most common anomaly (48%) and always required emergency surgical treatment; in addition there were two patients with stenosis of the left main coronary artery.

Conclusion

Coronary artery anomalies may be associated with very acute, even life-threatening symptoms in children, whereas they are usually clinically silent and detected by accident on coronary angiography in adults. Recognition of coronary artery anomalies enables early treatment or close follow-up in children, whereas it could be useful in case of cardiac surgery in adults.

Keywords

Congenital defectssudden deathcoronary arteriographyechocardiography
Type
Original Articles
Information
Cardiology in the Young , Volume 23 , Issue 3 , June 2013 , pp. 381 - 386
Copyright
Copyright © Cambridge University Press 2012 

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