Introduction to anomalous aortic origin of a coronary artery

Brothers, Julie A.

doi:10.1111/chd.12497

Cited by 25 publications

(20 citation statements)

References 14 publications

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“…There are four main types of AAOCA: (a) absence of left main artery; (b) abnormal origin of the coronary artery from the improper sinus; (c) anomalous coronary ostium outside of Valsalva's sinus; (d) a single coronary artery [1]. Although most coronary artery anomalies only have slight effects on individuals, some young individuals, who are prone to sudden cardiac death (SCD), typically exhibit the two common abnormality characteristics: RCA and abnormal LCA [4]. This study focused on the hemodynamics of the RCA originating from the left coronary sinus.…”

Section: Introductionmentioning

confidence: 99%

“…The anomalous origin of the coronary artery (AAOCA) is a common congenital coronary artery anomaly [ 1 ]. Although some children are born with AAOCA, the condition may not be diagnosed during coronary angiography until the individual grows to an adolescence or adulthood [ 2 – 4 ]. There are four main types of AAOCA: (a) absence of left main artery; (b) abnormal origin of the coronary artery from the improper sinus; (c) anomalous coronary ostium outside of Valsalva’s sinus; (d) a single coronary artery [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

Cong

Qiu

et al. 2020

BioMed Eng OnLine

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Background: The anomalous origin of the right coronary artery (RCA) from the left coronary artery sinus (AORL) is one of the abnormal origins of the coronary arteries. Most of these issues rarely have any effects on human health, but some individuals may exhibit symptoms, such as myocardial ischemia or even sudden death. Recently, researchers have investigated the AORL through clinical cases, but studies based on computational fluid dynamics (CFD) have rarely been reported. In this study, the hemodynamic changes between the normal origin of the RCA and the AORL are compared based on numerical simulation results. Methods: Realistic three-dimensional (3D) models of the 16 normal right coronary arteries and 26 abnormal origins of the RCAs were constructed, respectively. The blood flow was numerically simulated using the ANSYS software. This study used a one-way fluid-solid coupling finite element model, wherein the blood is assumed to be an incompressible Newtonian fluid, and the vessel is assumed to be made of an isotropic linear elastic material. Results: The cross-sectional area differences between the inlet of the normal group and that of the abnormal group were significant (P < 0.0001). Moreover, there were significant differences in the volumetric flow (P = 0.0001) and pressure (P = 0.0002). Positive correlation exists for the ratio of the cross-sectional area of the RCA to the inlet area of the ascending aorta (AAO), and the ratio of the inlet volumetric flow of the RCA to the volumetric flow of the AAO, in the normal (P = 0.0001, r = 0.8178) and abnormal (P = 0.0033, r = 0.6107) groups. Conclusion: This study demonstrates that the cross-sectional area of the AORL inlet may cause ischemia symptoms. The results obtained by this study may contribute to the further understanding of the clinical symptoms of the AORL based on the hemodynamics.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

Cong

Qiu

et al. 2020

BioMed Eng OnLine

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“…The AAOLCA can also take a course anterior to the right ventricular outflow tract (prepulmonic) or posterior to the aorta (retroaortic). These latter variants are generally considered benign although rare case reports of ischemia have been reported [2,4,5]. Much less is known about anomalous origin of the left coronary artery from the right aortic sinus associated with a subpulmonic intramyocardial course.…”

Section: Introductionmentioning

confidence: 99%

Anomalous origin of the left coronary artery from the right aortic sinus: probably benign variant associated with a subpulmonic intramyocardial course – a case report

et al. 2020

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Background: Anomalous aortic origin of the left coronary artery (AAOLCA) from the right aortic sinus is a rare congenital anomaly associated with significantly increased risk of myocardial ischemia, arrhythmias and sudden cardiac death. This refers specifically to AAOLCA associated with interarterial and/or intramural course. Much less is known about anomalous origin of the left coronary artery from the right aortic sinus associated with a subpulmonic intramyocardial course. Case presentation: We report a 12 year old girl who complained of recurrent episodes of chest pain lasting for some minutes and not associated to exercise. Echocardiography revealed AAOLCA from the right aortic sinus taking a subpulmonic course within the conal septum. The diagnosis was confirmed by CT-scan and selective coronary angiography. Treadmill test, Holter-ECG and bicycle-stress echocardiography revealed no evidence of myocardial ischemia reflecting unimpaired diastolic flow in the left coronary artery. According to the nature of the complaints and in the absence of signs of myocardial ischemia the episodes of chest pain were classified as idiopathic and not associated to the coronary anomaly. We opted for a conservative approach with regular follow-up visits. During a follow-up of 2 years without restriction of sports activities the patient has been asymptomatic. Conclusion: According to the literature AAOLCA with subpulmonary intramyocardial course appears to be associated with significantly less clinical problems than AAOLCA taking an interarterial course. The diagnosis can be suspected based on echocardiography and confirmed by contrast-enhanced computed tomography. Until now there are only few data concerning the natural history and incidence of complications in this specific anomaly. Despite the probably benign nature we recommend regular follow-up examinations including stress-testing in these patients.

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“…There are four main types of AAOCA: (a) absence of the left main artery, (b) abnormal origin of the coronary artery from the improper sinus, (c) anomalous coronary ostium outside of the Valsalva's sinus, and (d) a single coronary artery [5]. Although most coronary artery anomalies have little effects on individuals, some young people who are prone to sudden cardiac death usually have the two common characteristics of abnormal: RCA and abnormal LCA [6]. This study focused on the hemodynamics of the right coronary artery originating from the left coronary sinus.…”

Section: Introductionmentioning

confidence: 99%

Influence of malformation of right coronary artery originating from the left sinus on the hemodynamic environment

Cong

Qiu

et al. 2020

Preprint

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Background: The Anomalous origin of the Right Coronary Artery (RCA) from the Left Coronary artery sinus(AORL) is one of the abnormal origins of the coronary arteries. Most of these issues seldom have effects on human health, but some individuals may have symptoms such as myocardial ischaemia or even sudden death. Recently, researchers are studying AORL through clinical cases, but study based on computational fluid dynamics (CFD) is rarely seen. In this study, haemodynamic changes between normal origin of the RCA and AORL are compared according to numerical simulation results.Methods: Realistic three-dimensional models of 16 normal right coronary arteries and 26 abnormal origins of the right coronary arteries were reconstructed, respectively. The blood flow was numerically simulated using software ANSYS. This study involves one-way fluid-solid coupling finite element model in which the blood is assumed to be incompressible Newtonian fluid, and the vessel is assumed to be isotropic, linear elastic material. Results: The differences of the cross-sectional area at the inlet between the normal group and the abnormal group was significant (P<0.0001). There were significant differences in the volumetric flow (P=0.0001) and pressure (P=0.0002). There were positive correlations with the ratio of the cross-sectional area of the RCA to the inlet area of the ascending aorta (AAO) and the ratio of the inlet volumetric flow of the RCA to the volumetric flow of the AAO, in both the normal (P=0.0001, r=0.8178) and abnormal (P=0.0033, r=0.6107) group.Conclusion: This study shows that the cross-sectional area of the inlet of AORL may cause ischaemia symptoms, and the results may contribute to the further understanding of the clinical symptoms of AORL based on the haemodynamics.

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Introduction to anomalous aortic origin of a coronary artery

Cited by 25 publications

References 14 publications

Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

Influence of malformation of right coronary artery originating from the left sinus in hemodynamic environment

Anomalous origin of the left coronary artery from the right aortic sinus: probably benign variant associated with a subpulmonic intramyocardial course – a case report

Influence of malformation of right coronary artery originating from the left sinus on the hemodynamic environment

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