# Hypoplastic and Congenital Absence of Coronary Arteries and Its Correlation with Clinical Implications of Cardiac Circulation: A Systematic Review and Meta-Analysis

## TL;DR

This study reviews how underdeveloped or missing coronary arteries are linked to heart conditions and highlights the importance of recognizing these variants to avoid misdiagnosis.

## Contribution

The paper provides a systematic review and meta-analysis on hypoplastic and absent coronary arteries and their clinical implications.

## Key findings

- The pooled prevalence of coronary artery variants was 3% with high heterogeneity.
- Hypoplasia and agenesis are often incidental findings but can lead to misdiagnosis if not recognized.
- Surgical caution is needed for patients with these coronary artery variants.

## Abstract

Background: Coronary arteries originate from the first portion of the aorta, emerging from the right and left aortic sinuses. They traverse through the subepicardium and coronary sulcus to supply the myocardium during diastolic function. The objective of this review was to understand how the hypoplasia and agenesis of the coronary arteries are associated with cardiac pathologies. Methods: The databases Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS were researched until January 2024. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality. The pooled prevalence was estimated using a random effects model. Results: A total of three studies met the established selection criteria for inclusion in this meta-analysis. The prevalence of coronary artery variants was 3% (CI = 2% to 8%), with a heterogeneity of 77%. The other studies were analyzed descriptively, along with their respective clinical considerations in the presence of the variant. Conclusions: Hypoplasia and the congenital absence of the coronary arteries are often incidental findings and understanding these variants is crucial to prevent misdiagnosis. Additionally, it is essential to exercise caution when considering surgical management for hearts with these variants.