Anomalous origin of coronary artery from the opposite aortic sinus of Valsalva-a single center experience with a therapeutic conundrum

Lanjewar, Charan; Kumar, Dhiraj; Sabnis, Girish; Jare, Mahesh; Phutane, Mukund; Shah, Hetan; Reddy, S.V. Krishna; Borgaonkar, Devendra; Thummar, Ankur C.; Kerkar, Prafulla

doi:10.1016/j.ihj.2021.03.012

Cited by 4 publications

(5 citation statements)

References 23 publications

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“…Treatment options include surgical intervention, such as coronary artery unroo ng, ostial translocation, osteoplasty, and bypass grafting and/or conservative treatment, such as exercise restriction and medical treatment. Percutaneous coronary intervention is feasible in selected adult patients with AOCA and signi cant stenosis and a nonmalignant course (27,28). Stenting of anomalous coronary arteries is not currently considered a routine option for revascularization in growing children because of safety issues and the lack of size-matched interventional devices.…”

Section: Discussionmentioning

confidence: 99%

Congenital Anomalous Origin of the Coronary Artery in Children: Use of Computed Tomography Coronary Angiography for Diagnosis

Zhen

Dong

Jia

et al. 2023

Preprint

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Background AOCA can cause different degrees of myocardial ischemia. The various clinical presentations and diagnostic limitations of TTE often lead to missed diagnosis or misdiagnosis. Methods The retrospective study analysed the clinical date of 208 children with AOCA diagnosed by CT coronary angiography (CTCA), aimed to describe the clinical features and prognosis of the disease. Results One hundred and fifty-seven (75.5%) cases had cardiac symptoms, 3 (1.4%) had atypical symptoms, and 48 (23.1%) were asymptomatic. Levels of serological markers of myocardial injury were elevated in 49 patients (23.6%), and ST-T changes were predominant in electrocardiographic abnormalities (n = 140, 67.3%). Transthoracic echocardiography (TTE) identified 27 cases (13%) with cardiac enlargement and 10 (4.8%) with left ventricular systolic dysfunction. Only 6 cases (5.8%) of AOCA were identified by TTE, 4 of which were anomalous origin of the right coronary artery from the opposite sinus of Valsalva (R-ACAOS). The anomalous origin of the left coronary artery was the most common anomaly revealed (n = 126, 60.6%) by CTCA, followed by the anomalous origin of the right coronary artery (n = 50, 24.0%). Bilateral coronary arteries of anomalous origin were the least frequent (n = 32, 15.4%). Except for four cases who underwent surgical treatment, the others were treated conservatively. No deaths in the whole process. Conclusions CTCA has high diagnostic accuracy and can be used to determine the location and course of coronary ostia. The treatment of AOCA should be individualized according to the type of coronary origin, and surgical repair should be performed if necessary. Trial registration retrospectively registered.

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Section: Discussionmentioning

confidence: 99%

Congenital Anomalous Origin of the Coronary Artery in Children: Use of Computed Tomography Coronary Angiography for Diagnosis

Zhen

Dong

Jia

et al. 2023

Preprint

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“…Патологическое отхождение ОВ является наиболее частой аномалией отхождения коронарных артерий, в связи с чем Д. Эффлер еще в 1970 г. рекомендовал называть это «нормальный вариант» [3,4]. Расположение аномальной ОВ всегда одинаково: от своего начала она идет назад и влево, огибая аорту сзади, затем проходит между задней стенкой аорты и передней стенкой правого и левого предсердий, пока не достигнет своего расположения в левой части атриовентрикулярной борозды, где она прикрыта ушком левого предсердия и имеет обычное расположение [5].…”

Section: Introductionunclassified

A clinical case of the retroaortal course of the circumflex artery from the right coronary artery

Zakharyan,

Grigoriev,

Shatov

et al. 2023

Bûll. sib. med.

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An anomalous course of coronary arteries is fairly rare pathology, which, however, may underlie clinical manifestations of coronary artery disease. Expanding the possibilities of diagnostic coronary angiography makes it possible to detect numerous types of congenital anomalies of the coronary arteries.However, if earlier they were considered as angiographic findings and were characterized as benign, now this attitude has been changed due to reports of cases of syncope, angina pectoris, and sudden cardiac death associated with their presence. In this regard, a trend emerged to consider such anomalies as “potentially malignant”, which explains special caution at their detection. The article presents a clinical case of an anomalous retroaortic course of the circumflex artery from the right coronary artery.

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“…They are further categorised into two subtypes: anomalies of opposite sinus of Valsalva (OSV) origin, and anomalies of interarterial course. 5 Anomalies of OSV origin are coronary arteries that emerge from the opposite aortic sinus and run between the aorta and the pulmonary artery. This subtype comprises an anomalous LM from the right sinus, an anomalous right coronary artery from the left sinus, and an anomalous left circumflex artery from the right sinus.…”

Section: Introductionmentioning

confidence: 99%

“…The first aberrant pattern is regarded as the most threatening, since it raises the risk of sudden cardiac death (SCD) in those individuals. [5][6][7][8][9][10] Anomalies of termination relate to variations in the distribution and termination of the coronary arteries. They are further categorised into ALCAPA and coronary artery fistulas.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Coronary Intervention For Treatment of Unusual Origin of the Left Main Artery: A Case Report

Elkhayat,

Birema,

Elhoseiny

2023

EMJ Int Cardiol

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The left main coronary artery originating from the right sinus of Valsalva is a rare congenital anomaly. A 62-year-old male came in with recurring exertional chest discomfort, as observed by the authors. He was referred to the catheterisation laboratory for coronary angiography, which revealed the presence of a left main coronary artery coming from the right coronary sinus. In the proximal portion of the left anterior ascending coronary artery, a critical stenotic lesion was identified. The cardiac CT angiography demonstrated a benign retroaortic course. The lesion was effectively treated utilising three drug-eluting stents.

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Anomalous origin of coronary artery from the opposite aortic sinus of Valsalva-a single center experience with a therapeutic conundrum

Cited by 4 publications

References 23 publications

Congenital Anomalous Origin of the Coronary Artery in Children: Use of Computed Tomography Coronary Angiography for Diagnosis

Congenital Anomalous Origin of the Coronary Artery in Children: Use of Computed Tomography Coronary Angiography for Diagnosis

A clinical case of the retroaortal course of the circumflex artery from the right coronary artery

Percutaneous Coronary Intervention For Treatment of Unusual Origin of the Left Main Artery: A Case Report

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