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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Cardiovascular Surgery
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1489303

Surgical outcomes in adolescents and adults with anomalous aortic origin of a coronary artery

Provisionally accepted
Baotong Li Baotong Li 1*Li Ding Li Ding 2Hansong Sun Hansong Sun 1*
  • 1 Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, Beijing Municipality, China
  • 2 Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

The final, formatted version of the article will be published soon.

    Background: Anomalous aortic origin of a coronary artery (AAOCA) is associated with an increased risk of myocardial ischemia and sudden cardiac death. This study aims to evaluate the medium-term outcomes of surgical repair for AAOCA and to introduce a novel off-pump technique for anomalous coronary artery reimplantation.We retrospectively reviewed the medical records of 12 patients aged 12 years and older who underwent AAOCA surgery at Fuwai Hospital between 2009 and 2016.The median age at surgery was 26 years (range, 13 to 57 years). Patients with an anomalous left coronary artery from the right sinus (ALCA-R) were significantly younger than those with an anomalous right coronary artery from the left sinus (ARCA-L) (P<0.001). During a median follow-up of 13 years (range, 8 to15years), 11 patients had widely patent repaired coronary arteries, with the exception of one patient (case 5) who experienced occlusion of the left internal mammary artery graft 1 year post-CABG. The incidence of postoperative cardiactype symptoms (angina, syncope or dyspnea) was higher in ALCA-R patients compared to ARCA-L patients. Patch angioplasty using a pulmonary artery patch and RCA reimplantation without cardiopulmonary bypass yielded satisfactory medium-term outcomes.Compared with ARCA-L, the incidence of postoperative cardiac-type symptoms was higher in ALCA-R patients. Properly selected surgical procedures can lead to successful outcomes in patients with AAOCA. Patch angioplasty with a pulmonary artery patch and RCA reimplantation without cardiopulmonary bypass are viable and effective surgical options. CABG may not be the preferred surgical approach for AAOCA.

    Keywords: anomalous aortic origin of a coronary artery, coronary artery, surgical treatment, CABG, congenital cardiac anomaly

    Received: 31 Aug 2024; Accepted: 12 Nov 2024.

    Copyright: © 2024 Li, Ding and Sun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Baotong Li, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, Beijing Municipality, China
    Hansong Sun, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, Beijing Municipality, China

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.