Abstract on percutaneous coronary intervention in different anomalous coronary arteries-an observational study

Aims Anomalous coronary arteries are uncommon but clinically significant, depending upon its ostial origin, course and distribution, such patient may be asymptomatic or may present with angina, acute myocardial infarction, arrythmias, syncope and sudden cardiac death. Our aim is, to show the feasibility of percutaneous coronary intervention in those anomalous coronary arteries and also to assess the selection of hardwire in those particular cases. Methods and results Since January 2002 we have done 3110 PCI cases in NICVD and other cardiac centers in Dhaka. Out of which total twenty-one cases of PCI were performed in different varieties of anomalous coronary artery. Among those twenty-one cases, seven cases were PCI to high take off origin of RCA (33%), six cases were PCI to RCA of posterior origin (28%), three cases were PCI to RCA arising from left sinus of valsalva (14%), single case each for PCI to LCX as proximal branch of RCA (4.76%), PCI to LCX arises from right sinus of valsalva (4.76%), PCI to LAD arising separately from LSV (4.76%), PCI to LCX arising separately from LSV (4.76%), PCI to RCA where RCA and LM arising from RSV as a single stem (4.76%). We report here successful PCI in 20 (95%) cases having eight verities of anomalous coronary artery with failure in one case (4.76%). Conclusion PCI in anomalous coronary arteries is a feasible therapeutic strategy with excellent clinical results. Selection of appropriate guiding catheter and other equipment is essential to the technical success of the procedure. Since these cases are rare, the reported experience of other practitioners may provide helpful tips.