Purpose: The abnormal origin of the right coronary artery from the left coronary sinus（AORL）is very rare in clinic. The vast majority of patients have no clinical symptoms, but there are still a few patients with clinical symptoms such as chest tightness, chest pain, palpitation, and even sudden death. At present, the research of CT coronary angiography（CTA）is mostly limited to the detection rate of coronary abnormalities and some morphology. This experiment analyzes the hemodynamic parameters of AORL through computational fluid dynamics, so as to effectively evaluate the disease and provide basis for clinical intervention.
Methods: The discovery rate of AORL and the incidence of clinical symptoms were analyzed retrospectively, then the take-off angle of AORL with interarterial course was measured.The CTA images of AORL were modeled by Mimics, and the model was imported into ANSYS CFX software for hemodynamic simulation calculation.The blood is assumed to be an incompressible Newtonian fuid, and the vessel is assumed to be made of an isotropic linear elastic material.
Results: 82 patient（0.55%）with anomalous origin of the right coronary artery were most common in14820 patients with CTA，and 65 of them （79%）were accompanied by different degrees of clinical symptoms. The acute take-off angle was smaller in patients with clinical symptoms than in patients without clinical symptoms（P=0.016）. The wall pressure of AORL was significantly reduced than normal group (P＜0.001).
Conclusion: The AORL will cause hemodynamic changes, which may be related to the patient's clinical symptoms. This can help clinic evaluate the condition effectively.
Funding Support, Disclosures, and Conflict of Interest: This work was supported by Academic Promotion Program of Shandong First Medical University (2019QL009) Taishan Scholars Program of Shandong Province (TS201712065) Shandong medical and health science and technology development plan project(202009040454) Tai'an science and technology development plan project(2019NS156) Innovation and entrepreneurship training program(S202010439080) Innovation and entrepreneurship training program (202110439093)
IM- CT: Perfusion imaging, CTA, coronary artery calcium scoring