Echocardiographic diagnosis of clinically silent congenital coronary artery anomalies

Lytrivi, Irene D.; Wong, Austin H; Ko, H. Helen; Chandra, Samir; Nielsen, James C.; Srivastava, Shubhika; Lai, Wyman W.; Parness, Ira A.

doi:10.1016/j.ijcard.2007.04.063

Cited by 33 publications

(31 citation statements)

References 48 publications

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“…Congenital coronary anomalies are rare and reported mostly in autopsy series and preparticipation screening echocardiograms for athletes. 9,11,12 We found 5 anomalous RCAs from the left sinus of Valsalva and 1 LCA from the right sinus of Valsalva; this frequency is similar to that reported by Lytrivi et al 11 In their study, they had 4 times as many RCA from the left coronary sinus as LCA from the right coronary sinus. 7,9,10 Origin of the RCA from the left sinus of Valsalva has been less commonly associated with sudden cardiac death and ischemia.…”

Section: Discussionsupporting

confidence: 89%

“…[6][7][8][9] Anomalous origin of the LCA from the right sinus of Valsalva with interarterial/intramural course has been reported in numerous studies to be associated with sudden cardiac death during or immediately following strenuous exercise. 11 Finally, the KD screening echo revealed 12 bicuspid aortic valves, an incidence of 0.5% which correlates well with reported studies of 0.5% to 0.6% prevalence. 9,11,12 We found 5 anomalous RCAs from the left sinus of Valsalva and 1 LCA from the right sinus of Valsalva; this frequency is similar to that reported by Lytrivi et al 11 In their study, they had 4 times as many RCA from the left coronary sinus as LCA from the right coronary sinus.…”

Section: Discussionsupporting

confidence: 86%

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Prevalence of Undiagnosed Structural Heart Disease in Children Undergoing Echocardiography for Kawasaki Disease

Ronai

Baker

Friedman

et al. 2015

Clin Pediatr (Phila)

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 86%

Prevalence of Undiagnosed Structural Heart Disease in Children Undergoing Echocardiography for Kawasaki Disease

Ronai

Baker

Friedman

et al. 2015

Clin Pediatr (Phila)

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“…Others have now echoed this position. Lytrivi and her colleagues have questioned the utility of operating on all patients with ARCA and ALCA given the rarity of SCD and lack of knowledge on the exact mechanism [96]. Osaki and his group advocate expectant management and frequent reassessment in asymptomatic patients with AAOCA [26].…”

Section: Discussionmentioning

confidence: 99%

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Peñalver

Mosca

Weitz

et al. 2012

BMC Cardiovasc Disord

103

100

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BackgroundAnomalous aortic origin of the coronary artery (AAOCA) from the opposite sinus of Valsalva with an interarterial course has received much attention due to its association with sudden death in otherwise healthy individuals. AAOCA is relatively common and may have significant public health implications. While our knowledge of its pathophysiology and natural history remains incomplete, an emphasis has been placed on surgical correction.DiscussionIn 2005 we published a review examining the rates of sudden death with AAOCA, as well as complications of surgical management. Evidence now points even more strongly to lower rates of sudden death, while surgical outcomes data now better documents associated risks.SummaryArmed with this updated information, we agree with the need for a national registry to better track patients with AAOCA. We submit that the risks of surgical management outweigh any benefits in the asymptomatic patient with anomalous right coronary artery, and expectant management should also be strongly considered even in asymptomatic patients with anomalous left coronary artery.

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“…High takeoff of a coronary artery from the wall of the aorta is historically considered a normal variant. A recent publication by Lytrivi, et al presents the largest series to date of cases of clinically “silent” congenital coronary anomalies; 59 of 168 patients had “high coronary takeoff,” and all were either asymptomatic or undergoing evaluation for unrelated cardiac malformations 24 . However, there are case reports of sudden death in patients with high takeoff of a coronary artery 25,26 with no significant coronary atherosclerosis.…”

Section: Discussionmentioning

confidence: 99%

“…A recent publication by Lytrivi, et al presents the largest series to date of cases of clinically "silent" congenital coronary anomalies; 59 of 168 patients had "high coronary takeoff," and all were either asymptomatic or undergoing evaluation for unrelated cardiac malformations. 24 However, there are case reports of sudden death in patients with high takeoff of a coronary artery 25,26 with no significant coronary atherosclerosis. The majority of cases demonstrated a funnel-shaped ostium on pathologic review, some with intramural course of the initial portion of the coronary.…”

Section: Discussionmentioning

confidence: 99%

Anomalies of Left Coronary Artery Origin Affecting Surgical Repair of Hypoplastic Left Heart Syndrome and Shone Complex

et al. 2008

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There has traditionally been less concern regarding coronary anomalies with left-sided congenital heart lesions such as hypoplastic left heart syndrome (HLHS)or Shone complex than with other lesions. However, coronary anomalies in this setting can profoundly affect surgical intervention, particularly when surgical repair involves the ascending aorta. We describe four patients with congenital left-sided heart lesions in which left coronary artery (LCA) anomalies substantially affected intervention and outcome. In the first two cases, the coronary anomalies were not identified prospectively and resulted in surgical injury directly to the coronary or to its surrounding region. In the latter two cases, successful identification of the coronary anomaly preoperatively allowed for modification of surgical technique and/or intervention. We conclude that detailed coronary artery assessment should be part of the routine echocardiographic evaluation of congenital left-sided heart lesions that require surgery.

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Echocardiographic diagnosis of clinically silent congenital coronary artery anomalies

Cited by 33 publications

References 48 publications

Prevalence of Undiagnosed Structural Heart Disease in Children Undergoing Echocardiography for Kawasaki Disease

Prevalence of Undiagnosed Structural Heart Disease in Children Undergoing Echocardiography for Kawasaki Disease

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Anomalies of Left Coronary Artery Origin Affecting Surgical Repair of Hypoplastic Left Heart Syndrome and Shone Complex

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