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Surgery for anomalous aortic origin of the coronary artery

Muhammad A Mumtaz1, Richard E Lorber, Janine Arruda

  • 1Children's Cardiothoracic Surgery, Children's Hospital of the King's Daughters, Norfolk, Virginia 23507, USA. ali.mumtaz@chkd.org

The Annals of Thoracic Surgery
|March 1, 2011
PubMed

Insights

Coronary unroofing is a safe and effective treatment for anomalous aortic origin of the coronary artery (AAOCA) in symptomatic patients. This surgical approach demonstrated no complications in a recent study.

Area of Science:

  • Cardiovascular Surgery
  • Congenital Heart Disease
  • Pediatric Cardiology

Background:

  • Anomalous aortic origin of the coronary artery (AAOCA) is linked to serious cardiac events like ischemia and sudden death.
  • Advanced imaging techniques aid in identifying patients at risk for AAOCA complications.
  • Surgical unroofing is a primary treatment for AAOCA, addressing both symptomatic and asymptomatic cases.

Purpose of the Study:

  • To evaluate the safety and efficacy of coronary unroofing for treating anomalous aortic origin of the coronary artery.
  • To review surgical outcomes in patients with different types of AAOCA.
  • To assess the long-term patency of repaired coronary arteries.

Main Methods:

  • Coronary unroofing was performed on 22 patients with AAOCA between 1998 and 2008.
  • Patients included those with "left from right" and "right from left" AAOCA origins, presenting with various symptoms.
  • Concomitant procedures, such as patent foramen ovale closure, were performed in eight patients.

Main Results:

  • No deaths or surgical complications were reported in the study cohort.
  • The mean hospital stay was 4 days, with a mean cross-clamp time of 53 minutes.
  • Postoperative assessments confirmed the patency of the repaired coronary artery in all patients, with a mean follow-up of 17 months.

Conclusions:

  • Coronary unroofing is a safe and effective surgical option for symptomatic patients with anomalous aortic origin of the coronary artery.
  • The study highlights the emerging recognition of AAOCA as a distinct clinical entity.
  • Further prospective research is needed to clarify surgical indications for asymptomatic patients, particularly differentiating between "left from right" and "right from left" AAOCA.
Abstract

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