Repair of Anomalous Origin of Right Coronary Artery From the Left Sinus of Valsalva

Tavaf-Motamen, Houman; Bannister, Sean P.; Corcoran, Philip C.; Stewart, Robert W.; Mulligan, Charles R.; DeVries, William H.

doi:10.1016/j.athoracsur.2007.07.006

Cited by 45 publications

(35 citation statements)

References 4 publications

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“…However, early graft failure was reported in several cases. Tavaf-Motamen and colleagues theorized that the early failure is due to steal phenomenon at high levels of exertion [61] or competitive flow from patent native vessels contributing to graft thrombosis [62,63]. For this reason bypass grafting has been used less frequently.…”

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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“…82 The main disadvantage of arterial conduits is the potential for competitive flow down the ACAOS, which is minimally obstructed at rest, leading to graft closure. 65,83,84 Consequently, some clinicians have recommended ligation of the ACAOS proximal to the anastomosis between the artery and the graft. 81 Others advocate unroofing as the preferred surgical strategy, except where patients have con comitant atherosclerotic coronary disease, in which case CABG surgery is advised.…”

Section: Surgical Managementmentioning

confidence: 99%

Anomalous origination of a coronary artery from the opposite sinus

2011

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Anomalous origination of a coronary artery from the opposite sinus (ACAOS) is estimated to be present in 0.2-2.0% of the population. In the majority of individuals, ACAOS has no hemodynamic or prognostic implications, but in a minority of cases, typically where the anomalous coronary artery takes an interarterial course to reach its correct myocardial territory, it can precipitate ischemia and sudden cardiac death (SCD). With the growing use of CT coronary angiography (CTCA) in the investigation of ischemic heart disease, we can expect increasing rates of incidental detection of this anomaly. Although CTCA and magnetic resonance coronary angiography can effectively characterize these lesions anatomically, they fail to describe and quantitatively assess the basic defect that leads to coronary insufficiency, such as mural intussusception. The key challenge lies in the identification of which patients are at risk of SCD and, therefore, who should be offered corrective surgical or (potentially) percutaneous intervention. Conventional, noninvasive stress testing has limited sensitivity, but emerging, invasive stress tests, which utilize intravascular ultrasonography and measurements of fractional flow reserve, show the potential to provide more-accurate hemodynamic and prognostic assessment.

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“…Bypass surgery is associated with a higher rate of graft thrombosis 8 because of the competitive flow from the native vessels. This flow competition can be controlled by ligating the proximal portion of the bypassed vessel, but then the distal flow will rely on a conduit that might eventually suffer from attrition.…”

Section: Discussionmentioning

confidence: 99%

Wolff-Parkinson-White as a bystander in a patient with aborted sudden cardiac death

Laaouaj

Jacques

O’Hara

et al. 2016

HeartRhythm Case Reports

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Repair of Anomalous Origin of Right Coronary Artery From the Left Sinus of Valsalva

Cited by 45 publications

References 4 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

Anomalous origination of a coronary artery from the opposite sinus

Wolff-Parkinson-White as a bystander in a patient with aborted sudden cardiac death

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