Role of Multi-Detector Computed Tomography Coronary Angiography in the assessment of Congenital Coronary Artery Anomalies

Background: Congenital coronary artery anomalies (CCAAs) are rare but clinically significant conditions that can affect coronary circulation, potentially leading to adverse cardiac events. Accurate diagnosis and characterization are essential for appropriate management. Objective: This study aimed to evaluate the role of Multi-Detector Computed Tomography Coronary Angiography (MDCT-CA) in detecting and assessing congenital coronary artery anomalies in a large patient cohort. Methods: A total of 1000 patients who underwent MDCT-CA at Al-Azhar University Hospitals were evaluated. The study analyzed the prevalence, types, and characteristics of coronary artery anomalies, as well as variations in coronary artery anatomy, including dominance patterns, ramus intermedius artery, and myocardial bridging. Results: The study identified right coronary dominance in 84.6% of patients, left dominance in 7.6%, and co-dominance in 7.9%. The ramus intermedius artery was present in 31.4% of cases, and myocardial bridging was observed in 19%, with a higher prevalence in the left anterior descending artery (16%). The findings are consistent with previous literature and demonstrate the value of MDCT-CA in accurately diagnosing coronary artery anomalies and variations. Conclusion: MDCT-CA is a valuable non-invasive imaging modality for identifying and characterizing coronary artery anomalies.