Multi-Modality Imaging in Coronary Anomalies: Focus on Anomalous Aortic Origin of Coronary Arteries

Area of Science:

• Cardiology
• Congenital Heart Disease
• Diagnostic Imaging

Background:

• Coronary artery anomalies are congenital heart diseases affecting coronary artery circulation.
• Anomalous aortic origin of coronary arteries (AAOCA) is an underdiagnosed, potentially fatal condition, particularly in young athletes.
• Current management strategies for AAOCA lack universal consensus, leading to varied clinical approaches.

Purpose of the Study:

• To review the diagnostic approach and workflow for coronary anomalies.
• To analyze novel invasive functional methods for risk stratification in AAOCA.
• To address diagnostic uncertainties in asymptomatic or mildly symptomatic AAOCA patients.

Main Methods:

• Review of current literature on coronary artery anomalies and AAOCA.
• Discussion of diagnostic imaging techniques for AAOCA.
• In-depth analysis of novel angiographic invasive functional methods.

Main Results:

• Increased understanding of AAOCA pathophysiology and associated ischemic mechanisms.
• Identification of major risk conditions linked to AAOCA.
• Highlighting the uncertainty in risk stratification and management for AAOCA patients.

Conclusions:

• A comprehensive diagnostic approach is crucial for managing AAOCA.
• Novel invasive functional methods show promise in selected AAOCA cases.
• Standardized risk stratification and management guidelines are needed for AAOCA.