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Review
. 2024 Jul 8;14(13):1458.
doi: 10.3390/diagnostics14131458.

Anatomical Variants of the Origin of the Coronary Arteries: A Systematic Review and Meta-Analysis of Prevalence

Juan José Valenzuela Fuenzalida  1   2 , Emelyn Sofia Becerra-Rodriguez  3 , Alonso Sebastián Quivira Muñoz  1 , Belén Baez Flores  1 , Catalina Escalona Manzo  1 , Mathias Orellana-Donoso  4 , Pablo Nova-Baeza  1 , Alejandra Suazo-Santibañez  5 , Alejandro Bruna-Mejias  6 , Juan Sanchis-Gimeno  7 , Héctor Gutiérrez-Espinoza  8 , Guinevere Granite  9
Affiliations
Review

Anatomical Variants of the Origin of the Coronary Arteries: A Systematic Review and Meta-Analysis of Prevalence

Juan José Valenzuela Fuenzalida et al. Diagnostics (Basel). .

Abstract

Purpose: The most common anomaly is an anomalous left coronary artery originating from the pulmonary artery. These variants can be different and depend on the location as well as how they present themselves in their anatomical distribution and their symptomatological relationship. For these reasons, this review aims to identify the variants of the coronary artery and how they are associated with different clinical conditions.

Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. Two authors independently performed the search, study selection, and data extraction. Methodological quality was evaluated using an assurance tool for anatomical studies (AQUA). Pooled prevalence was estimated using a random effects model.

Results: A total of 39 studies met the established selection criteria. In this study, 21 articles with a total of 578,868 subjects were included in the meta-analysis. The coronary artery origin variant was 1% (CI = 0.8-1.2%). For this third sample, the funnel plot graph showed an important asymmetry, with a p-value of 0.162, which is directly associated with this asymmetry.

Conclusions: It is recommended that patients whose diagnosis was made incidentally and in the absence of symptoms undergo periodic controls to prevent future complications, including death. Finally, we believe that further studies could improve the anatomical, embryological, and physiological understanding of this variant in the heart.

Keywords: anatomical variation; clinical anatomy; coronary artery; left coronary artery (LCA); origin anomalous coronary artery; right coronary artery (RCA).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the included studies.
Figure 2
Figure 2
Different origins of coronary arteries. (A) shows a trans-septal course of the AC indicated in light red, while (B) shows the course of the AC anteriorly. (C) exemplifies a route of the retroaortic AC, whereas (D) shows an interatrial route of the AC.
Figure 3
Figure 3
Variations in the origins of coronary arteries. The image shows the different origins of the coronary arteries in which positions vary, whether from a high or low origin, a double origin in the different valves, or a more eccentric origin.
Figure 4
Figure 4
Forest plot of prevalence of variants of the origin of the coronary arteries.
Figure 5
Figure 5
Funnel plot of prevalence of variants of the origin of the coronary arteries.
Figure 6
Figure 6
The risk of bias in studies included, as determined using the AQUA checklist tool.
See this image and copyright information in PMC

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