Major congenital coronary artery anomalies in a paediatric and adult population: a prospective echocardiographic study

Labombarda, Fabien; Coutance, Guillaume; Pellissier, Arnaud; Mery-Alexandre, Claire; Roule, Vincent; Maragnès, Pascale; Milliez, Paul; Saloux, Éric

doi:10.1093/ehjci/jet287

Cited by 43 publications

(25 citation statements)

References 18 publications

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“…Angelini et al [18] reports a frequency of high risk anomalous coronaries as high as 0.44% in a population of middle and high school healthy volunteers. As described in other studies [1][2][3][4][5][6][18][19][20], we also found that interarterial AORCA was 3 times more frequent than AOLCA.…”

Section: Discussionsupporting

confidence: 90%

Anomalous aortic origin of coronary arteries: Early results on clinical management from an international multicenter study

Padalino

Franchetti

Sarris

et al. 2019

International Journal of Cardiology

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Background: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. Methods: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. Results: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p b 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p b 0.001). Conclusions: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal

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Section: Discussionsupporting

confidence: 90%

Anomalous aortic origin of coronary arteries: Early results on clinical management from an international multicenter study

Padalino

Franchetti

Sarris

et al. 2019

International Journal of Cardiology

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“…Several studies have attempted to quantify this value, with estimates ranging between 0.1% and 1.0% in both the adult and pediatric populations. [1][2][3][4][5][6][7] The wide difference in prevalence rates is likely due to RCA courses between aorta and pulmonary artery (interarterial) 4. Single LMCA arises from left sinus of Valsalva and bifurcates into the left anterior descending coronary and left circumflex coronary arteries.…”

Section: Section I: Background Prevalencementioning

confidence: 99%

Expert consensus guidelines: Anomalous aortic origin of a coronary artery

Brothers

Frommelt

Jaquiss

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

260

340

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Anomalous aortic origin of the right coronary artery. Central Message We sought to establish evidence-based guidelines for the management anomalous aortic origin of a coronary artery. Perspective Anomalous aortic origin of a coronary artery is associated with sudden cardiac death. Although the risk for any single affected individual is small, the loss of an otherwise healthy person is particularly devastating. Surgical and interventional therapies have been developed that appear to be protective but these therapies carry risks. The challenge is identifying those individuals at such risk.

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“…The incidence of congenital coronary anomalies ranges between 1 and 5% undergoing coronary angiography and 0.3% in autopsy series. [1,2] Echocardiographic studies in pediatric population reported an incidence of 0.3%. [3] Potentially serious coronary anomalies include ectopic coronary origin from the pulmonary artery, ectopic coronary origin from the opposite sinus, single coronary artery, and coronary fistula.…”

Section: Discussionmentioning

confidence: 99%

Inter-arterial course of left coronary artery in a case of non-specific chest pain

Demircan¹

2019

Cardiovasc Surg Int

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A 17-year-old female presented with a history of short and sharp chest pain which was not exacerbated by effort for one year. Computed tomography angiography revealed a left coronary artery arising from the right coronary sinus with inter-arterial compression. In conclusion, computed tomography angiography can give excellent information about the anomalous origin and course. A high index of suspicion is needed in the diagnosis of coronary artery anomalies with an insidious clinical course.

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Major congenital coronary artery anomalies in a paediatric and adult population: a prospective echocardiographic study

Abstract: MCA is a rare condition. TTE appears to be a potentially useful modality for the initial screening of MCA in adults and children, provided special attention is paid to coronary artery analysis.

Cited by 43 publications

References 18 publications

Anomalous aortic origin of coronary arteries: Early results on clinical management from an international multicenter study

Anomalous aortic origin of coronary arteries: Early results on clinical management from an international multicenter study

Expert consensus guidelines: Anomalous aortic origin of a coronary artery

Inter-arterial course of left coronary artery in a case of non-specific chest pain

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