Review coronary artery anatomy and normal anatomical variants. Provide a list of the most common congenital coronary artery anomalies. Discuss the role of coronary CT angiography in the diagnosis of such anomalies. Describe pertinent imaging findings on coronary CT angiography with multiplanar three-dimensional reconstructions. Discuss the clinical significance of an accurate diagnosis in the management of these anomalies.

Coronary Artery Anomalies (CAA) are a rare condition that can be found as an isolated finding or in conjunction with congenital heart disease. Many of the CAA are considered to be of no clinical significance. Only 20% of them have been found to be clinically significant, usually presenting with angina, myocardial infarction or sudden cardiac death. CAA is the second most common cause of sudden cardiac death among young athletes, after hypertrophic cardiomyopathy. Historically, conventional angiography was the gold standard for evaluating CAA. However, it...

I. Anomalies of Origin A. High Origin High origin CAA refers to the RCA or LCA arising 10mm above the sinotubular junction of the ascending aorta(Fig. 1, Fig. 6). It occurs most commonly on the RCA than the LCA, and is seen in patients with bicuspid aortic valve [6]. The importance of diagnosing a high origin CAA is that it may difficult coronary artery catheterization. Additionally, if aortic valve surgery or aortotomy is going to be performed, the ascending aorta should not be clamped inferior...

Coronary artery anomalies are a rare condition that can be found as an isolated finding or in conjunction with a congenital heart disease. Many of the coronary artery anomalies have been found to be of little or no clinical significance, yet coronary artery anomalies remain the second cause of sudden cardiac death among young athletes. CoronaryComputed Tomography Angiography (CCTA) has become the gold standard for diagnosing and classifying coronary artery anomalies as anomalies of origin, course or termination. Among the hemodynamically significant anomalies are the...

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