Anesthesia Management of Anomalous Aortic Origin of a Coronary Artery (AAOCA) Repair Revision

Abstract

Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare congenital cardiac condition with potentially lethal consequences. Variants of this condition accounts for the second leading cause of sudden cardiac death in children and adolescents. The incidence of detection of these anomalies is rising due to the improvement in imaging techniques. From our literature search, there are a few cases reported in the surgical journals, but none is about the anesthesia management. We report a case of AAOCA repair of a previously attempted and failed repair. In summary, anesthesia management of AAOCA depends on the type, anatomy, and pathophysiology of the anomaly. This patient's previous repair with graft resulted in a competing flow between her native RCA and the right internal mammary artery graft. Understanding and close monitoring of this flow dynamic is the key to manage such patients.