High Prevalence of Anatomical Variations and Anomalies of the Coronary Arteries Detected by CT Angiography in Symptomatic Patients

Objective: Coronary artery anatomical variations and anomalies are an important topic due to their potential clinical manifestations. This study aims to investigate the prevalence of coronary artery anatomical variations and anomalies in symptomatic patients with coronary computed tomography angiography (CCTA). Methods: This is a retrospective study that included all symptomatic patients who had CCTA in a tertiary care hospital in Saudi Arabia during a period of seven years. Results: The total number of included patients was 507 (60% males) with a mean age of 57.4 years. Approximately 41% had luminal stenoses, averaging 49.7%. The total number of patients with coronary anatomical variations (CAV) and coronary artery anomalies (CAA) was 217 (43%). CAV prevalence was 26%, which included 14% non-right coronary dominance, 5% short left main coronary artery (LMCA), and 7% division variations (trifurcation and quadrifurcarion) of the LMCA. The prevalence of CAA was 29%, which included 5% origin anomalies, 22% myocardial bridge, and 2% course anomalies. Conclusions: A high prevalence of coronary artery anatomic variations and anomalies in symptomatic patients is reported in this study. Systematic reviews, meta-analyses, reporting guidelines, and unified definitions and classifications of coronary variations and anomalies are lacking in the literature, presenting potential opportunities for future research and publications.