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.

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