Anomalous right coronary artery from the left coronary sinus, with an interarterial course

Schiano, P.; Lahutte, M.

doi:10.1016/j.acvd.2010.01.010

Cited by 5 publications

(5 citation statements)

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“…A small number of case reports claim successful use of beta-blockers in adults to treat this condition [83-86]. One study treated 56 adult patients with AAOCA and reported no episodes of SCD over a 5-year period [87].…”

Section: Discussionmentioning

confidence: 99%

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Peñalver

Mosca

Weitz

et al. 2012

BMC Cardiovasc Disord

106

100

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BackgroundAnomalous aortic origin of the coronary artery (AAOCA) from the opposite sinus of Valsalva with an interarterial course has received much attention due to its association with sudden death in otherwise healthy individuals. AAOCA is relatively common and may have significant public health implications. While our knowledge of its pathophysiology and natural history remains incomplete, an emphasis has been placed on surgical correction.DiscussionIn 2005 we published a review examining the rates of sudden death with AAOCA, as well as complications of surgical management. Evidence now points even more strongly to lower rates of sudden death, while surgical outcomes data now better documents associated risks.SummaryArmed with this updated information, we agree with the need for a national registry to better track patients with AAOCA. We submit that the risks of surgical management outweigh any benefits in the asymptomatic patient with anomalous right coronary artery, and expectant management should also be strongly considered even in asymptomatic patients with anomalous left coronary artery.

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Section: Discussionmentioning

confidence: 99%

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Peñalver

Mosca

Weitz

et al. 2012

BMC Cardiovasc Disord

106

100

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“…There are a small number of case reports using beta-blockers in adults to treat AAOCA. 126,127 The single largest series in the literature described 56 adult patients (average age 55.9 years) with beta-blockade and reported no episodes of SCD over a 5-year period. 99 In this study, however, there were no patients with AAOLCA and no patients younger than 30, both variables known to increase the risk of sudden death in patients with AAOCA.…”

Section: Percutaneous Coronary Interventionmentioning

confidence: 99%

Expert consensus guidelines: Anomalous aortic origin of a coronary artery

Brothers

Frommelt

Jaquiss

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

268

340

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Anomalous aortic origin of the right coronary artery. Central Message We sought to establish evidence-based guidelines for the management anomalous aortic origin of a coronary artery. Perspective Anomalous aortic origin of a coronary artery is associated with sudden cardiac death. Although the risk for any single affected individual is small, the loss of an otherwise healthy person is particularly devastating. Surgical and interventional therapies have been developed that appear to be protective but these therapies carry risks. The challenge is identifying those individuals at such risk.

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“…In 1 study including 42 predominantly adults with the right coronary artery originating from the left aortic sinus and an intramural proximal course, PCI relieved symptoms in 71% of subjects, but the rate of instent restenosis was 13% at a mean follow-up of 5 years. 49 As to medical treatments, few case reports 91,92 and only 2 large series 93,94 have been published. Whereas Kaku et al 93 described a cohort of 56 adults managed conservatively with exercise restriction or medical therapy (namely β-blockers, calcium channel blockers, nitrates, and antiarrhythmic drugs) and reported no SCD at a mean follow-up of 5.6 years, Opolski et al 94 showed that 19 of 70 (27%) medically managed patients reported a worsening in chest pain or diminished exercise tolerance at a mean follow-up of 1.3 years, particularly in those with interarterial course.…”

Section: Anomalies Of Originmentioning

confidence: 99%

Coronary Artery Anomalies

2021

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Coronary artery anomalies (CAAs) are a group of congenital conditions characterized by abnormal origin or course of any of the 3 main epicardial coronary arteries. Although CAAs have been identified as a common underlying condition in young athletes with sudden cardiac death, the widespread use of invasive and noninvasive coronary imaging has led to increased recognition of CAAs among adults. CAAS are often discovered as an incidental finding during the diagnostic workup for ischemic heart disease. The clinical correlates and prognostic implication of CAAs remain poorly understood in this context, and guideline-recommended therapeutic choices are supported by a low level of scientific evidence. Several studies have examined whether assessment of CAA-related myocardial ischemia can improve risk stratification in these patients, suggesting that multimodality imaging and functional tests may be key in the management of CAAs. The aim of this review is to outline definitions, classification, and epidemiology of the most relevant CAAs, highlighting recent advances and the potential impact of multimodality evaluation, and to discuss current therapeutic opportunities.

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Anomalous right coronary artery from the left coronary sinus, with an interarterial course

Cited by 5 publications

References 0 publications

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

Expert consensus guidelines: Anomalous aortic origin of a coronary artery

Coronary Artery Anomalies

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