The clinical anatomy of high take-off coronary arteries

A number of criteria are used in the literature to describe high take‐off coronary arteries, which can in part, explain the divide in the literature on the pathological significance of this anomaly. This study presents the anatomical variations of high take‐off coronary arteries to draw attention to the possible clinical implications they may cause during angiography and other surgical procedures. The English Literature was searched to review high take‐off coronary arteries. A high take‐off coronary artery arising at least 1 cm in adults or 20% the depth of the sinus in children above the sinutubular junction, is considered of greater clinical relevance and was included in our meta‐analysis. High take‐off coronaries by other criteria was also included as part of the comprehensive review. Exclusion criteria were reports made in case studies or case reviews. The prevalence of high take‐off coronary arteries in our study was 26 of 12,899 (0.202%). High take‐off coronary arteries were found to originate up to 5 cm above the sinutubular junction. Right coronary arteries made up 84.46% of high take‐off coronary arteries reported in the literature. Three (0.023%) cases that originated more than one centimeter above the sinutubular junction was associated with sudden cardiac death. This is a higher reported association than in studies that used other criteria for classification. It is important for clinicians to recognize the importance of correctly diagnosing high take‐off coronary arteries in patients with coexisting cardiac morbidities so that suitable management plans can be developed. Clin. Anat. 29:408–419, 2016. © 2015 Wiley Periodicals, Inc.