Coronary Artery Variants and Anomalies in Patients With Bicuspid Aortic Valve

The aim of this study was to assess the prevalence of variants and anomalies of the coronary arteries in patients with bicuspid aortic valve (BAV) and compare it with patients with tricuspid aortic valve (TAV).A total of 428 patients (193 with BAV, 235 with TAV) who underwent coronary computed tomography angiography were analyzed.The right coronary artery was dominant in 360 (84.1%) cases, including 157 (81.34%) with BAV and 203 (86.38%) with TAV. Left dominance was observed in 51 (11.9%) patients, including 30 (15.54%) with BAV 21 (8.93%) with TAV (P=0.08), and codominance in 17 (4%). The mean length of the left main coronary artery (LMCA) in patients with BAV was 10.45±6.93 versus 12.02±5.12 mm in those with TAV (P=0.008). The absence of the LMCA with separate origins of the left artery descending and the left circumflex artery was observed in 18 cases, 14/193 (7.3%) with BAV and 4/235 (1.7%) with TAV (P=0.004). The ramus intermedius was present in 50 (11.7%) patients, 29 with BAV (15%) and 21 with TAV (8.9%) (P=0.05). Coronary artery anomalies were observed in 2.1% of all patients (5/193 with BAV vs. 4/235 with TAV, P=0.5).The prevalence of anomalies of coronary arteries was similar in both groups. Patients with BAV had a higher incidence of the absence of the LMCA and the presence of the ramus intrermedius. The mean length of the LMCA in patients with BAV was shorter than in patients with TAV. There was a trend for a higher incidence of left dominance in patients with BAV compared to those with TAV, but did not reach statistical significance.