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Place of Angioplasty for Coronary Artery Anomalies With Interarterial Course

Pierre Aubry1,2, Xavier Halna du Fretay3, Olivier Boudvillain1

  • 1Bichat Hospital, Department of Cardiology, Paris, France.

Frontiers in Cardiovascular Medicine
|February 22, 2021
PubMed

Insights

Anomalous aortic origin of a coronary artery (AAOCA) in adults may benefit from percutaneous coronary intervention, especially for right AAOCA with interarterial course. This approach offers an alternative to surgery for preventing sudden cardiac death in this population.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Interventional Cardiology

Background:

  • Anomalous aortic origin of a coronary artery (AAOCA) is a congenital heart anomaly.
  • Current guidelines recommend surgical repair for AAOCA, primarily focusing on pediatric populations to prevent sudden cardiac death.
  • Existing guidelines lack evidence from randomized controlled trials and may not be optimal for adult patients.

Purpose of the Study:

  • To review the rationale for percutaneous coronary intervention (PCI) in adult patients with right anomalous aortic origin of a coronary artery (AAOCA) with an interarterial course.
  • To evaluate the published outcomes of PCI as a treatment for symptomatic right AAOCA in adults.
  • To address the current reluctance in surgical treatment for right AAOCA in adults presenting with ischemic symptoms.

Main Methods:

  • Literature review of studies reporting on percutaneous coronary intervention for anomalous aortic origin of a coronary artery.
  • Analysis of clinical outcomes, including efficacy and safety, of PCI in adult patients with right AAOCA.
  • Synthesis of evidence regarding the management of right AAOCA with interarterial course in the adult population.

Main Results:

  • Percutaneous coronary intervention is presented as a viable alternative to surgical correction for specific cases of right AAOCA in adults.
  • Published data suggests favorable outcomes for PCI in managing ischemic symptoms and myocardial ischemia associated with right AAOCA.
  • The review highlights the potential of PCI to address the limitations of current surgical recommendations in the adult demographic.

Conclusions:

  • Percutaneous coronary intervention offers a promising therapeutic option for adult patients with right anomalous aortic origin of a coronary artery (AAOCA) and interarterial course.
  • PCI may be particularly beneficial for adults experiencing ischemic symptoms or myocardial ischemia due to this anomaly.
  • Further research and randomized trials are warranted to solidify the role of PCI in the management of adult AAOCA.

Keywords:
angioplastyanomalous aortic origincongenital coronary anomalyinterarterial coursestenting

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