Abnormal origins of the coronary arteries from the aortic root

Abstract

Anomalous origin of a coronary artery from the aorta is a potentially serious anomaly that occurs in about 0.1-0.2% of the population. This percentage is small; however, it translates into about 4000 annual births with these anomalies. The clinical presentation of these anomalies is rare, and hence most are and will remain asymptomatic. The various anatomic anomalies are described, with anomalous origin of the left coronary artery that then passes between the aorta and pulmonary artery being the most serious of these anomalies. The pathophysiology resulting from these anomalies is described, as are methods for identifying those who require treatment; however, we still do not know the best methods of determining which patients need treatment.

The clinical anatomy of high take‐off coronary arteries

“…Several surgical techniques have been used in the treatment for high take‐off coronary arteries that coexist with other congenital anomalies with the aim of symptom reduction in patients: surgical reconstruction (Aoyagi et al, , Ntsinjana et al, ) coronary artery bypass using a saphenous vein or internal mammary artery graft (Tarhan et al, ), unroofing, neo‐ostium creation, and reimplantation. Exercise reduction and medical therapy with beta‐adrenergic blockers, calcium channel blockers, angiotensin‐converting enzyme blockers or nitrates have been used with some success to relieve the ischemic symptoms associated with some coronary vessel anomalies (Marler et al, in press; Hoffman, ).…”

Quality of life and exercise performance in unoperated children with anomalous aortic origin of a coronary artery from the opposite sinus of valsalva

“…[1][2][3][4][5][6][7][8] There are a number of anatomic variants of anomalous aortic origin of a coronary artery, some of which are benign and will never need surgical intervention or lifestyle modification; however, there are others that are potentially life-threatening and require surgical intervention. Despite the relatively small number of patients with this diagnosis, anomalous aortic origin of a coronary artery is the second leading cause of sudden cardiac death in young athletes [9][10][11][12][13][14][15][16][17][18] due to an increased risk of myocardial ischaemia, 1 especially during or immediately after exercise. 12,[16][17][18] Interarterial and commonly intramural anomalous aortic origin of the right coronary artery and anomalous aortic origin of the left coronary artery are the two most common variants.…”

Interobserver variability in the classification of congenital coronary abnormalities: A substudy of the anomalous connections of the coronary arteries registry

“…Computed tomography coronary angiography (CTCA) has shown its great accuracy to improve ANOCOR characterization . An appropriate classification is of great value to identify ANOCOR at risk . Whereas the recognition of the benign forms is equally important to reassure the patients.…”

“…[6][7][8] An appropriate classification is of great value to identify ANOCOR at risk. [9][10][11] Whereas the recognition of the benign forms is equally important to reassure the patients. As the prevalence of ANOCOR is low in the general population, most cardiologists and radiologists have only limited experience in this field.…”