Coronary artery disease in adults with anomalous aortic origin of a coronary artery

Jiang, Michael; Brinza, Ellen; Tucker, Dominique L.; Rajeswaran, Jeevanantham; Karamlou, Tara; Blackstone, Eugene H.; Saarel, Elizabeth V.; Gupta, Sohini; Hammoud, Miza Salim; Vaidya, Kiran A.; Haupt, Michael J.; Cockrum, Joshua; Mhanna, Christiane; Ghobrial, Joanna; Ahmad, Mahmood; Schoenhagen, Paul; Pettersson, Gösta; Najm, Hani K.; Stewart, Robert D.

doi:10.1016/j.xjon.2022.04.022

Cited by 13 publications

(7 citation statements)

References 37 publications

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“…Similarly, Schmitt et al reported an incidence of 2.5% (44 out of 1758 patients) [ 35 ], Duran et al reported a rate of 5.79% (42 out of 725 patients) [ 36 ], and Shi et al reported a rate of 6.6% (16 out of 242 patients) [ 37 ]. Our study also observed a higher prevalence of AAOCA in men compared to women, supporting previous findings from different studies [ 38 ].…”

Section: Discussionsupporting

confidence: 92%

“…In another study, there is no instances of cardiac death or adverse coronary events caused by the coronary anomaly during follow-up [ 43 ]. In addition, Jiang et al demonstrated that anomalous origin does not increase the severity of CAD within anomalous coronaries among adults with AAOCA [ 38 ], while an anomalous LCx was associated with increased stenosis not only in itself but also in other coronaries. Similarly, Click et al also shown that stenosis is significantly greater in an anomalous circumflex artery than in a non-anomalous circumflex artery in control subjects [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

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Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography

Li,

Hu,

Luo

et al. 2024

BMC Cardiovasc Disord

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Background Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital coronary anomaly with the potential to cause adverse cardiac events. However, there is limited data on the association between AAOCA and coronary artery disease (CAD). Therefore, the aim of this study is to determine the prevalence and symptoms of patients with AAOCA, as well as investigate the correlation between AAOCA and CAD in a population referred for coronary computed tomographic angiography (CTA). Methods and results All consecutive patients who underwent CTA from 2010 to 2021 were included. Characteristics, symptoms, coronary related adverse events and CTA information were reviewed by medical records. Separate multivariable cumulative logistic regressions were performed, using the stenosis severity in each of the four coronaries as individual responses and as a combined patient clustered response. Finally, we identified 207 adult patients with AAOCA, the prevalence of AAOCA is 0.23% (207/90,501). Moreover, this study found no significant association between AAOCA and CAD. AAOCA did not contribute to higher rates of hospitalization or adverse cardiac events, including calcification. Conclusion AAOCA is a rare congenital disease that is not associated with increased presence of obstructive CAD in adults.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography

Li,

Hu,

Luo

et al. 2024

BMC Cardiovasc Disord

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“…We underline that all 4 patients with LCx obstructive CAD had also obstructive plaques involving at least another vessel, showing a general greater burden of atherosclerosis if LCx is involved. Our data is not sufficient to distinguish if this is due to patient's predisposition to atherosclerosis or to the presence of the anomaly; however, the largest single‐center study on adult patients with ACAOS to date available (793 patients), 16 showed findings indicating that, compared to ACAOS of other coronaries, ALCx was associated with increased stenosis in not only the LCx itself but all the other coronaries. The authors proposed two possible reasons: (i) coronary hemodynamics, which could be altered in the anomalous LCx itself, due to the unusual length and retroaortic course, and in the overall coronary tree, given the smaller caliber of the anomalous LCx; (ii) timing of diagnosis with CCTA, considering that, possibly being the anomalous LCx a more benign variant, patients would become symptomatic at a later stage of coronary atherosclerosis, thus undergo CCTA and CAA diagnosis.…”

Section: Discussionmentioning

confidence: 67%

Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes

Ratti,

Prestini,

Conte

et al. 2023

Clinical Cardiology

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BackgroundAim of the study was to collect and describe a case series of consecutive master athletes in whom an anomalous origin of left circumflex artery (LCx) from the right sinus of Valsalva (ALCx) was detected at a clinically indicated coronary computed tomography angiography CCTA) to establish a focused clinical management and counseling about sport activity in those subjects.MethodsWe analyzed a prospective registry of subjects referred to a clinically indicated CCTA. Information about the clinical status was obtained by previous clinical records and clinical evaluation at time of image acquisition; follow‐up allowed to record symptoms, outcomes and downstream testing.ResultsThe study population consisted in 14 subjects, of which one competitive athlete and 13 recreational master athletes. Mean age was of 67.2 ± 10.6 years (71% of male); follow‐up lasted 6.4 ± 2.6 years. The major high‐risk anatomy features (inter‐arterial course, intramural segment, high take‐off and slit‐like ostium) were absent. None had abnormal ostial morphology and all had full retroaortic course; three subjects (21%) presented an acute take‐off angle. Coronary artery disease (CAD) was present in 10 patients (71%). Major outcomes (cardiac hospitalization, death for all causes) recorded were not related to the anomalous LCx. Symptoms were most related to atherosclerotic CAD in different vessels whereas two subjects without CAD exhibited cardiac symptoms, without hospitalization.ConclusionsOur study suggests that the diagnosis of ALCx, being usually associated to low‐risk anatomical characteristics, could be considered a benign finding, with scarce or no implications for physically active individuals neither for recreational athletes.

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“…Anatomy of vessels such as slit-like orifice, acute angle during takeoff, longer intramural course, the inter-arterial course between aorta and PA, and stenosis of the proximal coronary artery is associated with an increased risk of symptoms or SCD [ 11 , 44 ]. These factors need to be considered when making decisions regarding the management of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Percutaneous coronary intervention (PCI) has a limited role in CAA, particularly among young children. It may be considered in selective adult subjects with short intramural coronary artery, proximal coronary artery stenosis [ 44 ], or coronary artery fistula [ 40 ]. No large-scale study has compared the PCI and surgical approach for such procedures' long-term safety and efficacy [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Anomalies: A Short Case Series and Current Review

Alam¹,

Tasha²,

Ghosh³

et al. 2023

Cureus

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Coronary artery anomalies (CAAs) are rare congenital cardiovascular defects that can present in various ways depending on the origin, course, and termination of the abnormal coronary artery fistula. It is sometimes detected incidentally during procedures such as coronary angiography or autopsies. While adults with this condition are often asymptomatic, some may experience angina, congestive heart failure, myocardial infarction, cardiomyopathy, ventricular aneurysms, or sudden cardiac death (SCD). In fact, it is the second leading cause of SCD among young athletes and requires more studies to handle such patients efficiently. To illustrate the many possible manifestations of this unusual diagnosis, we present a series of five cases. We have also reviewed the different varieties of this rare congenital anomaly and discussed the latest diagnostic tests and treatment plans.

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Coronary artery disease in adults with anomalous aortic origin of a coronary artery

Cited by 13 publications

References 37 publications

Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography

Anomalous origin of the coronary artery: prevalence and coronary artery disease in adults undergoing coronary tomographic angiography

Anomalous origin of left circumflex artery from the right sinus of Valsalva: Clinical outcomes in a consecutive series of master athletes

Coronary Artery Anomalies: A Short Case Series and Current Review

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