Document Detail

Surgical repair of anomalous aortic origin of a coronary artery.
MedLine Citation:
PMID:  24431169     Owner:  NLM     Status:  Publisher    
OBJECTIVES: Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart defect that has been associated with myocardial ischaemia and sudden death. There is an ongoing controversy over the indications for surgical intervention and the efficacy of that treatment compared with the natural history. The purpose of this study was to evaluate the medium-term results of surgical repair of AAOCA.
METHODS: Seventy-six patients underwent surgical repair of AAOCA at our institution from 1999 to 2013. There were 55 males and 21 females, and the median age at surgery was 15 years. Forty-seven (62%) of the 76 patients had an anomalous right coronary artery, 27 had an anomalous left coronary and 2 had an eccentric single coronary ostia. Forty-one patients had preoperative symptoms of myocardial ischaemia.
RESULTS: Surgical repair was accomplished by unroofing of an intramural coronary in 55, reimplantation in 7 and pulmonary artery translocation in 14. There has been no early or late mortality, with a median duration of follow-up of 6 years. One patient presented with severe myocardial ischaemia and subsequently underwent heart transplantation a year following AAOCA surgery. The remaining patients have all remained free of cardiac symptoms.
CONCLUSIONS: The results of this study demonstrate two major principles. First, surgical repair of AAOCA is quite safe in centres that take care of a significant number of patients with this entity. Secondly, the surgery is highly effective in eliminating symptoms of myocardial ischaemia. The growing amount of data on postoperative patients suggests that surgical repair can prevent the adverse events seen in the untreated 'natural' history. Based on these observations, it is our current recommendation that all teenagers identified with AAOCA should undergo surgical repair.
Richard D Mainwaring; V Mohan Reddy; Olaf Reinhartz; Edwin Petrossian; Rajesh Punn; Frank L Hanley
Related Documents :
3709559 - A case of anomalous origin of the right coronary artery from the left sinus of valsalva...
3759429 - Perforation of the esophagus electrocardiographically mimicking myocardial infarction.
16702749 - Myocardial infarction caused by aspergillus embolization in a patient with aplastic ane...
15746719 - Ventricular septal hamartoma mimicking hypertrophic cardiomyopathy in a 41-year-old wom...
169939 - Value of infarct-specific isotope (99mtc-labelled stannous pyrophosphate) in myocardial...
10783419 - Clinical policy: critical issues in the evaluation and management of adult patients pre...
19684189 - Postinfarction gene therapy with adenoviral vector expressing decorin mitigates cardiac...
8537149 - Involvement of inducible nitric oxide synthase in the inflammatory process of myocardia...
21700089 - Monomorphic ventricular tachycardia and mediastinal adenopathy due to granulomatous inf...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-1-14
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  -     ISSN:  1873-734X     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2014 Jan 
Date Detail:
Created Date:  2014-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  How should aortic arch aneurysms be treated in the endovascular aortic repair era? A risk-adjusted c...
Next Document:  Transcatheter aortic valve implantation through carotid artery access under local anaesthesia.