A report of fifty cases with incidental diagnosis of anomalous origin of the right coronary artery from the left sinus of Valsalva

Amirreza Sajjadieh Khajouei; Pedram Payandeh; Sayed Ali Emami; Manizheh Danesh

doi:10.1016/j.ijcard.2024.132063

A report of fifty cases with incidental diagnosis of anomalous origin of the right coronary artery from the left sinus of Valsalva

Int J Cardiol. 2024 Jul 1:406:132063. doi: 10.1016/j.ijcard.2024.132063. Epub 2024 Apr 21.

Authors

Amirreza Sajjadieh Khajouei¹, Pedram Payandeh², Sayed Ali Emami³, Manizheh Danesh⁴

Affiliations

¹ Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
² Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
³ Heart Failure Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
⁴ Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran. Electronic address: Danesh.manizheh@gmail.com.

PMID: 38648913
DOI: 10.1016/j.ijcard.2024.132063

Abstract

Introduction: Anomalous origin of the right coronary artery from the left sinus of Valsalva (R-ACAOS) is a relatively rare condition that can potentially lead to devastating outcomes. The current study aims to investigate the cardiac-related disorders among patients with incidental R-ACAOS diagnosis through computed tomography angiography (CTA).

Methods: The current cross-sectional study has been conducted on 50 patients diagnosed with R-ACAOS who underwent CTA. Based on CTA, the patients' were categorized as R-ACAOS with interarterial course and non-interarterial course. The demographic and medical characteristics, any history of cardiac intervention and New York Heart Association (NYHA) Functional Classification at the time of diagnosis were recruited. Patients were revisited to assess cardiac-associated variables, including symptoms, the presence of heart failure and current NYHA function class.

Results: The variables including the history of cardiac intervention (P-value<0.001), the presence of heart failure (P-value = 0.010) and NYHA function class at the time of diagnosis (P-value = 0.006) were remarkably higher among those with interarterial course of R-ACAOS; while, the other variables including chest pain at rest (P-value = 0.55) or on exertion (P-value = 0.12), current NYHA function class, current cardiac-associated symptoms except for dyspnea at rest (P-value = 0.012), mortality and coronary calium score did not differ (P-value>0.05). coronary interventions led to significantly improved NYHA function class (P-value<0.05).

Conclusion: Based on the findings of the current study, R-ACAOS with interarterial course leads to significantly higher rates of atherosclerotic-related symptoms and events compared with the other types of RCA anomalies. Moreover, coronary interventions led to significantly improved NYHA functional class regardless of R-ACAOS category.

Keywords: Computed tomography angiography; Coronary angiography; Coronary artery anomalies; Sinus of Valsalva.

MeSH terms

Adult
Aged
Computed Tomography Angiography* / methods
Coronary Angiography / methods
Coronary Vessel Anomalies* / diagnosis
Coronary Vessel Anomalies* / diagnostic imaging
Cross-Sectional Studies
Female
Humans
Incidental Findings*
Male
Middle Aged
Sinus of Valsalva* / abnormalities
Sinus of Valsalva* / diagnostic imaging