Comment on the article Diagnosis, risk assessment, and surgical planning of coronary artery anomalies by CT angiography

Coronary computed tomography angiography (CCTA), which enables detailed visualization of coronary anatomy, is increasingly identifying coronary artery anomalies (CAA). The study by Orhan et al. caught our attention by evaluating CCTA findings in 2,786 patients and reporting a CAA prevalence of 1.82%. The study offers significant anatomical data; however, various methodological and interpretive elements require elucidation. The reported prevalence may be affected by the application of a non-standard threshold for identifying high take-off coronary origins, which could restrict comparability with previous studies and lead to an overestimation of clinically significant anomalies. Moreover, the reported female predominance of malignant interarterial courses is derived from a very limited subgroup, which raises concerns about the robustness of the statistics. Finally, conclusions regarding the role of CCTA in surgical planning are not supported by outcome data. Standardized definitions and studies incorporating clinical follow-up are needed to better define the clinical implications of CCTA-detected coronary anomalies.