Subclinical changes suggestive of ischemia might occur despite patent neo-coronary ostia, notably after ARCA repair. The implication of these results on indication for surgery and subsequent sudden death risk is unknown. Serial EST, SE, and MPS are essential in evaluating ongoing ischemia risk after AAOCA repair.

Objective We sought to evaluate exercise performance and quality of life in children after surgical repair of anomalous aortic origin of a coronary artery with an interarterial course. Methods Patients who had surgery 10/2001–1/2007 were eligible for inclusion. Exercise performance and quality of life were prospectively assessed by maximal exercise tests and age-appropriate questionnaires, respectively. We used t-tests to compare pre- and post-operative exercise data and quality of life scores to published normative data. We performed linear regression analyses to assess associations between demographic, anatomic, and exercise variables and quality of life score. Results Of 25/27 patients, 64% were male, 68% had anomalous right coronary, 32% were asymptomatic. Average age at surgery was 10.8 (±4.1) years; median follow-up was 14.5 (2–48) months. Post-operative percent-predicted exercise values were: peak heart rate 97 (±6), working capacity 91 (±15), maximal oxygen consumption 82 (±16). In those who underwent pre-operative exercise testing (n=11), resting and maximal heart rates decreased significantly without significant change in exercise performance. Average child quality of life was 85/100 (±13) and parent-proxy 88 (±11) compared to normal scores of 83 (±15) and 88 (±12), respectively (p=NS). Conclusion There is mild chronotropic impairment in children and adolescents following anomalous coronary artery repair without a decline in exercise performance. This does not appear to impair their overall quality of life. Since long-term effects on heart rate, exercise performance, and quality of life are unknown, serial exercise tests should be included as routine care of these patients. We evaluated exercise performance and quality of life following repair of anomalous coronary artery in children. There was mild chronotropic impairment post-operatively despite maintenance of exercise performance and quality of life. Since long-term effects of surgical repair are unknown, serial exercise tests should be included as routine care.

No abstract

No abstract