Variants in origin of the left circumflex coronary artery with angiography

OBJECTIVE: The objective of this study was to assess the anatomic variations in the origin of the left circumflex coronary artery in a Turkish population.

METHODS: This study was carried out at the Sani Konukoklu Medical Center, Gaziantep, Turkey, during the period January 1999 through to May 2001. The angiographic data of 10,042 consecutive adult patients who underwent coronary angiography was analyzed for anomalous origin of the left circumflex coronary artery.

RESULTS: Among 10,042 adults patients, 27 (0.3%) had anomalous origin of the left circumflex coronary artery. The left circumflex coronary artery arose from the left coronary sinus of valsalva in 15 (55.5%) patients, from the right coronary sinus of valsalva in 7 (25.9%) patients, and from the proximal part of the right coronary artery in 8 (29.6%) patients.

CONCLUSION: The anomalous origin of the left circumflex coronary artery may not always be benign. Therefore, recognition of this anomaly is mandatory to prevent the risk of infarction or sudden death. Special surgical considerations must be made when performing valvular replacement in patients with anomalous left circumflex coronary artery.