Anomalous Aortic Origin of a Coronary Artery: Toward a Standardized Approach

• Published in: Seminars in thoracic and cardiovascular surgery Vol. 26; no. 2; pp. 110 - 122
• Main Authors: Mery, Carlos M., MD, MPH, Lawrence, Silvana M., MD, PhD, Krishnamurthy, Rajesh, MD, Sexson-Tejtel, S. Kristen, MD, PhD, Carberry, Kathleen E., RN, MPH, McKenzie, E. Dean, MD, Fraser, Charles D., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2014
• Subjects: Algorithms; anomalous aortic origin of a coronary artery; Cardiac Surgical Procedures - adverse effects; Cardiac Surgical Procedures - mortality; Cardiac Surgical Procedures - standards; Cardiology - standards; Cardiothoracic Surgery; coronary anomalies; Coronary Vessel Anomalies - diagnosis; Coronary Vessel Anomalies - mortality; Coronary Vessel Anomalies - surgery; Critical Pathways - standards; Death, Sudden, Cardiac - etiology; Death, Sudden, Cardiac - prevention & control; Diagnostic Imaging - standards; Humans; Predictive Value of Tests; Prevalence; Risk Assessment; Risk Factors; sudden cardiac death; Treatment Outcome; anomalous aortic origin of a coronary artery; coronary anomalies; sudden cardiac death
• ISSN: 1043-0679; 1532-9488
• DOI: 10.1053/j.semtcvs.2014.08.001

Anomalous aortic origin of a coronary artery (AAOCA) is a congenital abnormality of the origin or course of a coronary artery that arises from the aorta. It is the second most common cause of sudden cardiac death in young athletes. Its exact prevalence, the pathophysiological mechanisms that cause sudden cardiac death, the actual risk of death for the different types of AAOCA, the optimal way to evaluate these patients, and whether any treatment strategies decrease the risk of sudden cardiac death in patients diagnosed with AAOCA are unknown. This article analyzes what is currently known and unknown about this disease. It also describes the creation of a dedicated multidisciplinary coronary anomalies program and the development of a framework in an initial attempt to standardize the evaluation and management of these patients.