Yetişkinlerde koroner arter anomalilerinin analizi: morfoloji, ateroskleroz ve kardiyovasküler riskler

Abstract

Amaç: Konjenital koroner arter anomalileri, perkütan veya cerrahi girişimlerde oldukça önemlidir. Yetişkin popülasyonda nadir görülen koroner arter anomalileri, anjiyografi, cerrahi müdahale ve otopsi sırasında tespit edilmektedir. Bu çalışmanın amacı, koroner anjiyografi uygulanan yetişkinlerde konjenital koroner arter anomalilerinin insidansını belirlemektir. Yöntemler: Lokman Hekim Akay Hastanesi'nde Mayıs 2007 ile Ekim 2010 tarihleri arasında gerçekleştirilen tüm koroner anjiyografi kayıtları incelendi. Koroner arter anomalileri, Dr. Angelini tarafından önerilen sınıflamaya göre değerlendirildi. Bulgular: Bu çalışmada toplamda 12.457 koroner anjiyografi kaydı incelendi. Koroner arter anomalileri, yaşları 19 ile 97 arasında değişen 134 (%0,93) kişide (89 erkek, 45 kadın) tespit edildi. Miyokardiyal köprüler 62 (%0,49) olguda, koroner arter çıkış anomalileri 22 (%0,1) olguda, koroner arter anevrizmaları 31 (%0,2) olguda, koroner arter fistülleri 18 (%0,1) olguda ve koroner arter atreziyası ise 1 olguda saptandı. Sonuç: Bu seride elde edilen sonuçlar, önceki çalışmalarla yüksek oranda tutarlılık göstermiştir. Koroner arter anomalilerinin cerrahi operasyonlardan önce anjiyografik olarak tespit edilmesi ve gerektiğinde anomali tipine göre yeniden düzenlenmesi önemli olduğu düşünülmektedir.

Keywords

• Koroner arter anomalileri
• koroner arter anjiografisi
• ani ölüm

Analysis of coronary artery anomalies in adults: morphology, atherosclerosis, and cardiovascular risks

Abstract

Aims: Despite their rarity, coronary artery anomalies (CAAs) warrant careful consideration during percutaneous or surgical interventions due to their potential influence on clinical outcomes. The objective of this study was to ascertain the prevalence and characteristics of CAAs in adult patients undergoing coronary angiography. Methods: A retrospective analysis was conducted on 12.457 coronary angiography records from a tertiary hospital, encompassing the period from May 2007 to October 2010. The classification of anomalies adhered to the system proposed by Dr. Angelini and approved by the Congenital Heart Surgery Committee. Statistical comparisons were performed through the application of Student’s t-test, Pearson’s chi-square test, and Fisher’s exact test. Results: An analysis of angiographies identified CAAs in 134 cases, consisting of 89 males and 45 females, with an age range spanning from 21 to 87 years . Myocardial bridging was identified in 62 instances (0.49%), coronary artery exit anomalies in 17 instances (0.14%), coronary artery aneurysms in 30 instances (0.24%), coronary artery fistula in 18 instances (0.14%) , and coronary artery atresia in one instance (0.01%). There were no substantial gender variations observed among the different types of anomalies. Conclusion: The findings of this study align closely with previous research concerning the prevalence and characteristics of CAAs. Prompt diagnosis and angiographic assessment of congenital CAAs are essential for optimal management and minimizing procedural risks. Anatomical knowledge is indispensable in elucidating pathophysiological mechanisms, optimizing surgical strategies, and advancing diagnostic imaging techniques.

Keywords

• Coronary angiography
• coronary artery anomalies
• myocardial bridging
• sudden death
• congenital anomalies

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