Circulation, Vol 53, 122-131, Copyright © 1976 by American Heart Association
BR Chaitman, J Lesperance, J Saltiel and MG Bourassa
Clinical and angiographic features of 31 patients with anomalous coronpary
artery origin are reviewed. Of 17 aberrant circumflex arteries from the
right sinus of Valsalva or artery, each was retro- aortic, six
atherosclerotic, and seven irrigated a small area of myocardium. Of seven
anomalous right coronary arteries from the left sinus of Valsalva or
artery, each was ante-aortic and two atherosclerotic. Aberrant origin of
the circumflex or right coronary artery was a benign anomaly. The proximal
course of seven aberrant left coronary arteries from the right sinus of
Valsalva or right coronary artery was related to clinical events. The
anomaly was best demonstrated in the lateral view. In five cases, coronary
blood flow during exercise and myocardial metabolism during pacing were
assessed. Two had had a previous infarction with nonatherosclerotic
arteries. Exercise coronary blood flow was normal in four and low in one
patient. Pacing resulted in lactate production in two with atherosclerotic
and one without atherosclerotic arteries. We conclude that anomalous left
coronpary origin from the right sinus of Valsalva can result in significant
myocardial ischemia and infarction.
ARTICLES
Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries
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