Congenital variations of coronary artery anatomy

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During the past 20 years (1958 to 1978), more than 64,000 coronary arteriograms were performed at the Cleveland Clinic. During the course of this experience, a variety of anatomical variants were observed, some of which were clinically significant, causing symptoms, affecting cardiac function, or influencing prognosis. This report will attempt to review the spectrum of anomalies encountered during the first generation of coronary arteriography, define their incidences during a specific segment of time, and discuss their clinical significance.


During the first generation of coronary arteriography, many of the more unusual anomalies of the coronary circulation have been collected individually by staff members of the Department of Cardiology. An attempt has been made to compile these records, which include most, but not all, of the clinically significant anomalies. In 1972, a computerized registry was initiated that would serve as a repository of data for cardiovascular patients, initially those undergoing cardiac catheterization or surgical treatment at the Cleveland Clinic. Currently, the Cardiovascular Information Registry contains information on more than 42,000 patients. Data acquisition is more than 99% complete for all patients undergoing catheterization or surgery from 1973 to 1978, and more than 98% complete for 1972 patients. This data base was surveyed for coronary anomalies identified during the first 7 years of the registry through 1978. Catheterization reports, clinical records, and in many instances cineangiograms were reviewed of patients with coronary anomalies for accuracy and completeness. Patients catheterized in other institutions were excluded. A coronary anomaly was defined as any abnormality . . .



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