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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

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Coronary Artery Anomalies

Francesco Gentile1, Vincenzo Castiglione1, Raffaele De Caterina1,2

  • 1Cardiology Division, Pisa University Hospital, Italy (F.G., V.C., R.D.C.).

Circulation
|September 20, 2021
PubMed

Insights

Coronary artery anomalies (CAAs), congenital heart conditions, are increasingly found in adults. Understanding their impact and improving diagnosis with imaging are crucial for patient management.

Area of Science:

  • Cardiology
  • Congenital Heart Disease
  • Medical Imaging

Background:

  • Coronary artery anomalies (CAAs) are congenital conditions affecting coronary artery origin or course.
  • While linked to sudden cardiac death in athletes, CAAs are increasingly identified incidentally in adults during ischemic heart disease workups.
  • The clinical significance and prognostic implications of CAAs in adults are not well understood, with limited evidence for treatment guidelines.

Purpose of the Study:

  • To review definitions, classification, and epidemiology of significant CAAs.
  • To highlight recent advancements in understanding and diagnosing CAAs.
  • To discuss the role of multimodality imaging and functional tests in managing CAAs and explore therapeutic options.

Main Methods:

  • Literature review of coronary artery anomalies.
  • Analysis of diagnostic approaches including invasive and noninvasive coronary imaging.
  • Evaluation of studies on CAA-related myocardial ischemia and risk stratification.
  • Review of current therapeutic strategies for CAAs.

Main Results:

  • CAAs are common incidental findings in adults undergoing evaluation for ischemic heart disease.
  • Multimodality imaging and functional tests show promise in assessing CAA-related ischemia and improving risk stratification.
  • There is a need for more evidence to guide therapeutic choices for CAAs.

Conclusions:

  • CAAs require further investigation, particularly regarding their clinical impact in adults.
  • Multimodality imaging plays a vital role in the evaluation and management of patients with CAAs.
  • Enhanced understanding and evidence are needed to optimize treatment strategies for coronary artery anomalies.

Keywords:
coronary vesselsdeath, sudden, cardiacheart defects, congenitalmyocardial ischemia

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