Coronary Anomalies in Children

Abstract

Coronary anomalies are uncommon congenital variations in coronary anatomy, occurring in 0.2-1.2% of the general population, the majority of which are detected incidentally and have little clinical significance. A minority of congenital coronary anomalies, primarily due to an interarterial course, are clinically significant, and may present with symptoms of myocardial ischemia, malignant ventricular arrhythmias, and even sudden cardiac death. This chapter focuses on the anatomic features, mode of presentation, diagnostic findings, and surgical treatments that are available for the two most common types of isolated congenital coronary anomalies that are associated with myocardial ischemia during childhood: (1) anomalous origin of a coronary artery from the pulmonary artery and (2) anomalous origin of a coronary artery from the opposite sinus of Valsalva with an interarterial course between the great arteries. A brief discussion of coronary artery fistulous connections completes the chapter.