European Radiology

, Volume 24, Issue 10, pp 2353–2359 | Cite as

Anomalous origin of the coronary artery from the wrong coronary sinus evaluated with computed tomography: “High-risk” anatomy and its clinical relevance

  • Maciej KrupińskiEmail author
  • Małgorzata Urbańczyk-Zawadzka
  • Bartosz Laskowicz
  • Małgorzata Irzyk
  • Robert Banyś
  • Piotr Klimeczek
  • Katarzyna Gruszczyńska
  • Jan Baron



The aim of the study was to assess coronary arteries arising from the wrong coronary sinus, including CT-evaluated high-risk anatomic features, clinical symptoms and cardiac events during follow-up.


A total of 7,115 patients scheduled for 64-slice or dual-source cardiac CT were screened for the presence of isolated anomalous origin of the coronary artery from the wrong coronary sinus.


Anomalous origin of the coronary artery was found in 54 (0.76 %) patients (29 men, 25 women, mean age 60.9 ± 11.6 years). Sixteen (30 %) patients with abnormal right coronary origin (ARCA) more commonly had a slit-like orifice (15 vs. 3; p < 0.001), intramural course (15 vs. 3; p < 0.001) and interarterial course (11 vs. 0; p < 0.001) than 22 (41 %) and 13 (24 %) individuals with abnormal circumflex artery (ALCx) and left coronary artery (ALCA) origin, respectively. Patients with ALCA presented less frequently with chest pain than subjects with ARCA and ALCx (25 vs. 3; p = 0.03). Patients with ARCA tended to show higher occurrence of cardiac events in the follow-up than individuals with ALCA and ALCx (5 vs. 4; p = NS).


High-risk anatomy features are most common in patients with ARCA and these patients also have higher prevalence of chest pain and cardiac events in the follow-up than individuals with ALCA and ALCx.

Key Points

Multislice computed tomography enables detection and evaluation of the coronary artery anomalies.

Anomalous anatomy of the coronary artery potentially influences the prevalence of adverse events.

Adverse events tend to be most common in anomalous right coronary arteries.


Multislice computed tomography Coronary vessel anomalies Follow-up studies Cardiovascular abnormalities Anatomy 



Anomalous origin of the circumflex artery from the right coronary artery sinus


Anomalous origin of the right coronary artery from the left coronary artery sinus


anomalous origin of the left coronary artery from the right coronary artery sinus


Coronary artery bypass grafting


Invasive coronary angiography


Percutaneous coronary interventions



The scientific guarantor of this publication is Dr Małgorzata Urbańczyk-Zawadzka, Head of the Department of Radiology and Diagnostic Imaging, John Paul II Hospital, Krakow, Poland. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. One of the authors has significant statistical expertise. Institutional Review Board approval and written informed consent were not required because this is a primarily retrospective study. In the follow-up patients were contacted and asked if any cardiac events had occurred. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.


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Copyright information

© European Society of Radiology 2014

Authors and Affiliations

  • Maciej Krupiński
    • 1
    Email author
  • Małgorzata Urbańczyk-Zawadzka
    • 1
  • Bartosz Laskowicz
    • 1
  • Małgorzata Irzyk
    • 1
  • Robert Banyś
    • 1
  • Piotr Klimeczek
    • 1
  • Katarzyna Gruszczyńska
    • 2
  • Jan Baron
    • 2
  1. 1.Department of Radiology and Diagnostic ImagingJohn Paul II HospitalKrakówPoland
  2. 2.Department of Radiology and Nuclear MedicineMedical University of SilesiaKatowicePoland

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