Anomalous Aortic Origin of a Coronary Artery in Pediatric Patients

Abstract

Purpose of Review We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA). Recent Findings Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention. Anomalous right coronary artery from the left aortic sinus (R-AAOCA) carries a much lower risk and stress perfusion imaging is helpful in identifying patients with inducible ischemia. Perfusion abnormalities resolve following successful surgical intervention of AAOCA. Computational modeling techniques identifying risk features shows promise in the evaluation of AAOCA. Summary Stress perfusion imaging is helpful in assessing AAOCA upon presentation and following surgical intervention. Computational modeling has potential in bridging knowledge gaps in AAOCA.