Abstract
Background: The aims of this study were to assess the prevalence of anatomical variation of coronary arteries among Sudanese patients using cardiac computed tomography angiography (CTA) and to identify the pathological finding for patients undergoing cardiac CTA.
Methods and Results: This prospective cohort study was conducted with 87 Sudanese patients subjected to cardiac CTA examination, using a 64-slice CT scanner (Aquillon 64, Toshiba Medical Systems, Tochigi, Japan) with retrospective ECG gating. Data were collected from 3D reconstruction at optimal phase. The numbers of diagonal and obtuse marginal branches were counted. The presence of ramus intermedius and origination of the right coronary artery (RCA) from right coronary sinus (RCS) were also reported.
Findings showed that most patients had one (33.3%) or two (47.1%) diagonal artery branches. In addition, 3.4% of patients had no diagonal branches, 12.6% had three and 3.4% had more than three diagonal branches arising from the left anterior descending artery (LAD). About 8% of our patients had no obtuse marginal branch. The majority of patients had one, two and three branches of the obtuse marginal arising from a left circumflex artery, which amounted to 24.1%, 41.4% and 25.3%, respectively. Only one patient had more than three obtuse marginal branches. Furthermore, 94.3% of patients presented with RCA originating from RCS, and 5.7% of patients had an ectopic origin of the left coronary artery (LCA).
Conclusion: This study concluded that there is a wide variation in the number of diagonal and obtuse marginal branches arising from the left circumflex artery among Sudanese patients. Ramus intermedius was the most common anatomical variation affecting the coronary artery. Ectopic origination of the RCA is a very rare condition in Sudanese patients.