Anatomical variations in the coronary arteries. II. Less prevalent variations: Coronary anomalies

With the introduction of new surgical procedures an the development of new techniques of cardiac imaging, the normal anatomy, variations and anomalies of coronary arteries have assumed new significance. The coronary arteries may present several variations, in terms of both number and position. The incidence of all coronary anomalies is 0.23% in autopsy series and ranges between 0.3% and 12% in angiographic series. Variations with a prevalence in the general population of less than 1% are therefore considered as coronary anomalies, and in many cases, their presence affects or may affect the subject's quality of life and even their survival. The coronary anomalies of the main coronary arteries are described following a criteria based on the origin of the anomalous vessel: ectopic aortic origin, origin from the pulmonary artery or origin from a systemic artery. Finally, the congenital coronary continuity and the coronary fistulas are reviewed.