Anomalous aortic origin of a coronary artery (AAOCA): A case report
A Anwar1, K M J Chan2, Y Awang2
1Cardiac Vascular Sentral Kuala Lumpur (CVSKL) Hospital, Department of Cardiothoracic Surgery, Kuala Lumpur, Malaysia. anwar_azrin@yahoo.com.
Insights
Anomalous aortic origin of a coronary artery (AAOCA) is a rare condition causing heart ischemia. Surgical repair via coronary artery bypass graft (CABG) offers a successful treatment option for symptomatic patients.
Area of Science:
- Cardiology
- Cardiac Surgery
- Medical Imaging
Background:
- Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart defect with significant risk of myocardial ischemia and sudden cardiac death.
- Symptoms often include exertional chest pain, dyspnea, or dizziness, necessitating prompt diagnosis and management.
Observation:
- A 46-year-old female presented with exertional chest pain and a positive stress test.
- CT angiography (CTA) confirmed the diagnosis of AAOCA.
Findings:
- The patient underwent successful coronary artery bypass graft (CABG) surgery utilizing a saphenous vein graft.
- The right internal mammary artery (RIMA) was deemed unsuitable for use due to poor flow and flimsy quality.
Implications:
- Surgical revascularization, such as CABG, is an effective treatment for symptomatic AAOCA.
- This case highlights the importance of CTA in diagnosing AAOCA and guiding surgical strategy.
Abstract:
Anomalous Aortic Origin of a Coronary Artery (AAOCA) is a rare anomaly of the coronary artery with a considerable risk of sudden cardiac death due to ischaemia of the heart. Symptoms may include chest pain on exertion, breathlessness or dizziness. We encountered a case of a 46- year-old female who complained of exertional chest pain with a positive-stress test and subsequently diagnosed with AAOCA through CT angiography (CTA). She successfully underwent a coronary artery bypass graft (CABG) surgery using a saphenous vein graft with uneventful recovery. Right internal mammary artery (RIMA) was not used as it was flimsy and the flow was very poor.
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