Anomalous Aortic Origin of a Coronary Artery in Pediatric Patients

Authors

Tam T Doan
Charles Puelz
Craig Rusin
Silvana Molossi

Publication Date

1-1-2024

Journal

Current Pediatrics Reports

DOI

10.1007/s40124-024-00317-7

PMID

39816672

PMCID

PMC11729077

PubMedCentral® Posted Date

5-24-2024

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Anomalous aortic origin of a coronary artery, Sudden cardiac death, Sudden cardiac arrest, Inducible myocardial ischemia, Computational modeling, Children

Abstract

PURPOSE OF REVIEW: We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA).

RECENT FINDINGS: Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention. Anomalous right coronary artery from the left aortic sinus (R-AAOCA) carries a much lower risk and stress perfusion imaging is helpful in identifying patients with inducible ischemia. Perfusion abnormalities resolve following successful surgical intervention of AAOCA. Computational modeling techniques identifying risk features shows promise in the evaluation of AAOCA.

SUMMARY: Stress perfusion imaging is helpful in assessing AAOCA upon presentation and following surgical intervention. Computational modeling has potential in bridging knowledge gaps in AAOCA.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40124-024-00317-7.