Major congenital coronary artery anomalies in a paediatric and adult population: a prospective echocardiographic study.

AIMS

We sought to describe our experience with major coronary anomalies (MCAs) diagnosed in transthoracic echocardiography (TTE) in a large adult and paediatric population. MCAs may have serious clinical consequences. No echocardiographic studies have prospectively screened MCA in a general adult and paediatric population.

METHODS AND RESULTS

From June 2008 to January 2012, a systematic search for MCA was prospectively conducted in children and adult patients, coming for a TTE. Three thousand five hundred and two patients (84% adults and 16% children) underwent a TTE. Fourteen coronary anomalies (0.39%) were diagnosed: nine anomalous origins of coronary artery from the opposite sinus with inter-arterial course, one abnormal left coronary artery from the pulmonary artery, three single coronary ostia, and one coronary fistula. Cardiac symptoms initiated investigation in seven patients. Five patients underwent specific surgery: two coronary reimplantations and three coronary bypass grafting. Ten patients had already undergone at least one TTE with the anomalous coronary artery being neither diagnosed nor suspected.

CONCLUSIONS

MCA is a rare condition. TTE appears to be a potentially useful modality for the initial screening of MCA in adults and children, provided special attention is paid to coronary artery analysis.