Abstract
Few patients with an anomalous aortic origin of a coronary artery (AAOCA) require a correction of this congenital anomaly. Current recommendations offer surgical repair as a first line therapy to prevent a sudden cardiac death as a main objective. However, these guidelines are focused on children and not based on randomized controlled studies. Furthermore, decision-making should be different in an adult population less exposed to the risk of sudden cardiac death. Current practices showed reluctance to offer a surgical treatment for right AAOCA associated with ischemic symptoms or myocardial ischemia. Our aim in this review is to expose the rationale for percutaneous coronary intervention in right AAOCA with interarterial course and to present the published results.
Highlights
Diagnosis of an anomalous aortic origin of a coronary artery (AAOCA) is not rare in the adult population
R-AAOCA constitutes a major part of congenital coronary anomalies possibly responsible for ischemic symptoms or myocardial ischemia
The management of patients with RAAOCA remains controversial in the adult population
Summary
Diagnosis of an anomalous aortic origin of a coronary artery (AAOCA) is not rare in the adult population. The first presentation of these anomalies, so-called AAOCA at risk, is variable, ranging from an incident finding to ischemic symptoms or sudden cardiac death (SCD). The latter is rarely the first event in adults >35 years of age [3]. When an AAOCA correction is offered, surgical intervention is recommended in current guidelines. The latter are generally focused on young people [5, 6]. This work describes the experience and point of view of a French team dedicated to the ANOmalous CORonary arteries: the ANOCOR Working Group
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