Anomalous Aortic Origin of a Coronary Artery: Surgical Repair With Anatomic- and Function-Based Follow-Up

Anomalous Aortic Origin of a Coronary Artery: Symptoms Do Not Correlate With Intramural Length or Ostial Diameter

“…anomalous aortic origin of a coronary artery CTA computed tomography angiography MACEs major adverse cardiac events MRI magnetic resonance imaging OR operating room Surgical unroofing has emerged as the current surgical procedure of choice, although other techniques may be appropriate in select cases. 10,11 In 2011, we reported a possible correlation of symptoms with intramural coronary length in this patient population. 12 Because approximately half of all patients with sudden cardiac death have prior symptoms, [13][14][15] if intramural length can be shown to correlate with symptoms, it would assist in the decision tree for surgery.…”

“…The results of surgical intervention as reported by several major institutions are quite good 10,[24][25][26][27][28][29][30] (Table 4). In a collected series of over 450 patients, there was no reported mortality.…”

Surgical Treatment of Anomalous Aortic Origin of Coronary Arteries: The Reimplantation Technique and Its Modifications

“…Feins and coauthors presented 1 of the largest series with 259 patients managed for AAOCA. 11 Sixty-one underwent surgical intervention, but 26 with associated coronary artery disease were excluded. Thirty-one patients who underwent surgical repair were analyzed.…”

Surgical management of anomalous coronary arteries

“…PA translocation has been proposed by the Stanford group (18,34,35) for instances in which unroofing of a relatively short intramural segment results in the ostium remaining in the wrong sinus, resulting in persistence of an inter-arterial course. Repairs that rely upon extranatomic sources of coronary blood flow, such as coronary artery bypass grafting using either saphenous vein grafts or internal mammary artery grafts, are generally not preferred in children and young adults, due to possible long-term graft patency issues, but may be considered in older adults (36). Other less common methods not covered in the video lecture include simple osteoplasty without unroofing, creation of ostial window-partial unroofing to fashion a neo-ostium in the distal intramural segment-and aortocoronary anastomosis © Annals of Cardiothoracic Surgery.…”