origin :- These include:
- The origin of
the left main ( LM ), left anterior descending (LAD), left circumflex
(LCx) or right coronary artery (RCA)from the pulmonary trunk (the left
or right ventricles, the bronchial, internal mammary, subclavian, right
carotid, or innominate arteries or the aortic arch or descending thoracic
- High takeoff of
the left or right coronary ostia, defined as the location of the ostium
of the left or right coronary artery more than 1 cm above the Sino-tubular
- The anomalous
location of the coronary ostium within the aortic root, near the proper
aortic sinus of Valsalva (for each artery) or outside normal “coronary”
- The absent left
main trunk (split origination of the left coronary artery (LCA).
Anomalous origin and course :- The entire coronary artery
system may originate from a single ostium located in the left or right
coronary sinus of the aorta
- The LM originates from the RCA, or vice versa taking aberrant pathways;
- Separate origin of the LAD and LCx from the right coronary artery.
- Both the left and right coronary arteries may arise from a separate
ostia located in the same, either left or right, sinus of the aorta.
Anomalous course and termination
- An intermyocardial ; course (i.e., the myocardial bridge).
coronary arteries may terminate abnormality into one of the cardiac chambers
(the right or left atrium, the right or left ventricle), coronary sinus,
superior vena cava, pulmonary artery, pulmonary vein and, thus, produce
fistulas originating from:
- The left (50-60%);
- The right (30-40%);
- Or both (2-5%
coronary artery systems.
- A membrane or
a fibrotic ridge usually causes congenital epicardial coronary artery
- Coronary artery
atresia is characterized by the presence of an ostial dimple in the
left or right aortic sinus that terminates in a patent lumen.
- Hypo plastic coronary
arteries have a small luminal diameter (usually <1 mm ) and reduced
length. The latter is often associated with the absence of the posterior
descending coronary artery.
- Coronary ectasia
- The absent coronary