Standardized Approach to Patients With Anomalous Aortic Origin of a Coronary Artery: Results From the Coronary Anomalies Program at Texas Children’s Hospital

Molossi, Silvana; Mery, Carlos M.; Krishnamurthy, Rajesh; Sexson, Kristen; Carberry, Kathleen E.; Watrin, Carmen H.; Reaves, Dana; Masand, Prakash; McKenzie, Dean Philip; Fraser, Charles D.

doi:10.1016/s0735-1097(15)60501-0

Cited by 5 publications

(4 citation statements)

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“…Basso et al 9 3.3% presented with SCA. 16 Brothers and Harris 17 reported limited episode of exercise-induced ventricular tachycardia in a patient with ARCA and this also observed in our series 16 interestingly with no report of palpitations. Nuclear stress perfusion (NSP) imaging is also often utilized in these patients to evaluate myocardial perfusion and both false-positive and false-negative results question its reliability to identify true myocardial ischemia.…”

Section: N I Ca L Pr E Sen Ta Ti Onsupporting

confidence: 82%

“…In 90 patients (mean age 11.8 ± 4.2, range of 0.08–19 years) evaluated at the Coronary Anomalies Program at Texas Children's Hospital created in December 2012, to December 2014, 51% were asymptomatic, 29% had chest pain (54% on exertion, 23% on both exertion and at rest and 23% only at rest), 15% had syncope (57% on exertion), and 3.3% presented with SCA . Brothers and Harris reported limited episode of exercise‐induced ventricular tachycardia in a patient with ARCA and this also observed in our series interestingly with no report of palpitations.…”

Section: Clinical Presentationmentioning

confidence: 99%

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Clinical evaluation of anomalous aortic origin of a coronary artery (AAOCA)

Molossi

Agrawal

2017

Congenital Heart Disease

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The clinical evaluation of patients with an anomalous aortic origin of a coronary artery (AAOCA), a congenital abnormality of the origin or course of a coronary artery that arises from the aorta, is challenging given its first presentation being sudden cardiac arrest in about half of the patients. Symptoms of chest pain, shortness of breath and syncope during exertion should be of concern in evaluating young athletes and nonathletes. The lack of abnormal signs on the physical exam and electrocardiogram further adds to the difficulty in establishing the diagnosis. Additional imaging with echocardiography, computed tomography angiography and/or cardiac magnetic resonance imaging (MRI) is often needed and establishes the diagnosis. High-risk lesions include origin of the coronary artery from the opposite sinus of Valsalva, intramural course and ostial abnormalities (stenosis, hypoplasia). Functional studies should be performed to assess myocardial perfusion at rest and during stress, such as nuclear imaging, stress echocardiography and stress cardiac MRI.

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Section: N I Ca L Pr E Sen Ta Ti Onsupporting

confidence: 82%

Section: Clinical Presentationmentioning

confidence: 99%

Clinical evaluation of anomalous aortic origin of a coronary artery (AAOCA)

Molossi

Agrawal

2017

Congenital Heart Disease

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“…12 In our experience with AAOCA, 51% of patients were asymptomatic, 29% had chest pain, 15% had syncope, and 3.3% presented with SCA. 20 Of those presenting with SCA, one had a previous diagnosis of asthma and used his inhaler when he felt short of breath during exercise, one had been evaluated for syncope following exertion that was deemed vasovagal in nature, and two were completely asymptomatic.…”

Section: Diagnosis and Evaluationmentioning

confidence: 99%

Anomalous Aortic Origin of a Coronary Artery

Molossi

Martínez-Bravo

Mery

2019

Methodist DeBakey Cardiovascular Journal

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“…Of these, 35% underwent surgical intervention, and all have returned to exercise activities with no restrictions postoperatively. 50 This area remains obscure where many questions are yet to be answered. However, efforts nationwide are ongoing to gather meaningful data with longitudinal follow-up of patients with AAOCA that will allow better risk stratification and, it is hoped, decrease the occurrence of SCD and unnecessary exercise restriction in these patients.…”

Section: Coronary Anomalies-congenital and Acquired Anomalous Aortic mentioning

confidence: 99%