Objective To compare the prevalence and patterns of anomalous coronary artery origin from the opposite sinus (ACAOS) in patients with bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV). Methods Retrospective review of consecutive patients with surgically excised BAV and TAV was performed from 1994 to 2015. Clinical notes, echocardiograms, coronary angiograms, CT angiographies, and pathology reports were reviewed. ACAOS included right coronary artery from the left cusp, left circumflex artery from the right cusp and left main or left anterior descending artery from the right cusp. Results 2371 (years 1994–2015) and 1679 (years 2009–2015) consecutive patients with pathology-confirmed BAV and TAV, respectively, and defined preoperative coronary anatomy were identified. A left dominant coronary circulation was present in 386 (18%) patients with BAV and 179 (11%) patients with TAV (p<0.001). ACAOS was identified in 43 (1.8%) patients with BAV and 15 (0.9%) patients with TAV, p=0.02. Among patients with BAV and ACAOS, the most common phenotype was right-left fusion (n=34, 79%) with present raphe (n=36, 84%), with no association between BAV phenotype and ACAOS type. On multivariate analysis, BAV status and size of the mid-ascending aorta were independently associated with ACAOS (OR 3.29; CI 1.26 to 8.6; p=0.02; OR 0.93; CI 0.87 to 0.98; p=0.01; respectively). Only two patients with ACAOS, one with BAV and one with TAV, had a perioperative coronary ischaemic event. Conclusions The prevalence of the potentially malignant ACAOS is significantly higher (threefold higher odds) in patients with BAV as compared with TAV, yet remains uncommon in absolute terms. Most patients with BAV and ACAOS had right-left cusp fusion and present raphe. Perioperative coronary events are rare in patients with ACAOS. All data relevant to the study are included in the article. Due to confidentiality issues, the datasets and study materials safe guarded by the Health Science Department of Mayo Clinic cannot be made available to outside parties.

中文翻译：

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二尖瓣主动脉瓣患者冠状动脉起源于对侧窦的异常：与三尖瓣主动脉瓣的比较

目的比较二尖瓣主动脉瓣（BAV）和三尖瓣主动脉瓣（TAV）患者冠状动脉起源于对侧窦（ACAOS）异常的发生率和模式。方法 对 1994 年至 2015 年连续手术切除的 BAV 和 TAV 患者进行回顾性研究。回顾性分析临床记录、超声心动图、冠状动脉造影、CT 血管造影和病理报告。ACAOS包括来自左尖瓣的右冠状动脉、来自右尖瓣的左回旋支和来自右尖瓣的左主干或左前降支动脉。结果 分别确定了 2371 名（1994-2015 年）和 1679 名（2009-2015 年）经病理证实为 BAV 和 TAV 并确定术前冠状动脉解剖结构的连续患者。386 名 (18%) BAV 患者和 179 (11%) 名 TAV 患者存在左冠脉优势循环 (p<0.001)。在 43 (1.8%) 名 BAV 患者和 15 (0.9%) 名 TAV 患者中发现 ACAOS，p=0.02。在 BAV 和 ACAOS 患者中，最常见的表型是左右融合 (n=34, 79%) 与现有中缝 (n=36, 84%)，BAV 表型和 ACAOS 类型之间没有关联。在多变量分析中，BAV 状态和中升主动脉的大小与 ACAOS 独立相关（OR 3.29；CI 1.26 至 8.6；p=0.02；OR 0.93；CI 0.87 至 0.98；p=0.01；分别）。只有两名 ACAOS 患者发生了围手术期冠状动脉缺血事件，一名患有 BAV，一名患有 TAV。结论 与 TAV 相比，BAV 患者潜在恶性 ACAOS 的患病率显着更高（几率高出三倍），但绝对值仍然不常见。大多数 BAV 和 ACAOS 患者有左右牙尖融合和中缝。ACAOS 患者的围手术期冠状动脉事件很少见。与研究相关的所有数据都包含在文章中。由于保密问题，由梅奥诊所健康科学部保护的数据集和研究材料不能对外提供。