Abstract
Anomalous aortic origin of a coronary artery (AAOCA) is reported as the second leading cause of sudden cardiac death in otherwise healthy young individuals. Several surgical studies have reported a shallow operative risk, describing repair as safe and effective with short or medium-term follow-up. However, surgical repair can also be associated with a high risk of complications. Numerous repair techniques have been described in the literature, but each technique's indications and limitations are often not well-understood or understated. Since explicit technical knowledge of the most appropriate surgical technique is highly desirable, we sought to thoroughly and clearly outline the safeguards and pitfalls of the most common surgical techniques used to repair AAOCA.
Highlights
Anomalous aortic origin of a coronary artery (AAOCA) is reported as the second leading cause of sudden cardiac death in otherwise healthy young individuals
Anomalous aortic origin of a coronary artery (AAOCA) is a congenital heart defect consisting of an abnormal origin and course of a coronary artery that arises from the aorta and differs from the usual pattern (Figure 1A)
The most common and clinically relevant anomaly is the anomalous origin from the opposite sinus of Valsalva, including the more common anomalous origin of the right coronary artery from the left aortic sinus (AAORCA, Figure 1B), and the more morbid anomalous origin of the left coronary artery arising from the right aortic sinus (AAOLCA, Figure 1C) (1)
Summary
The most common and clinically relevant anomaly is the anomalous origin from the opposite sinus of Valsalva, including the more common anomalous origin of the right coronary artery from the left aortic sinus (AAORCA, Figure 1B), and the more morbid anomalous origin of the left coronary artery arising from the right aortic sinus (AAOLCA, Figure 1C) (1). This congenital anomaly is the second leading cause of sudden cardiac death (SCD) in otherwise healthy young adults (2–4).
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