Anomalous aortic origin of coronary arteries from the opposite sinus: A critical appraisal of risk

BMC Cardiovascular Disorders

Debate

Ralph S Mosca¹  Josiah M Peñalver²  Colin KL Phoon²  Daniel Weitz³ 

[1] Department of Cardiothoracic Surgery, Division of Pediatric and Adult Congenital Cardiac Surgery, 530 First Avenue, Suite 9-V, 10016, New York, NY, USA;Department of Pediatrics, Division of Pediatric Cardiology, 160 East 32nd Street, L-3, 10016, New York, NY, USA;Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, 550 First Avenue, 10016, New York, NY, USA;

关键词: Coronary artery anomaly;    Sudden cardiac death;    Anomalous aortic origin of the coronary artery;    Heart defects;    Congenital;   

DOI  :  10.1186/1471-2261-12-83

 received in 2012-02-17, accepted in 2012-08-27,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundAnomalous aortic origin of the coronary artery (AAOCA) from the opposite sinus of Valsalva with an interarterial course has received much attention due to its association with sudden death in otherwise healthy individuals. AAOCA is relatively common and may have significant public health implications. While our knowledge of its pathophysiology and natural history remains incomplete, an emphasis has been placed on surgical correction.DiscussionIn 2005 we published a review examining the rates of sudden death with AAOCA, as well as complications of surgical management. Evidence now points even more strongly to lower rates of sudden death, while surgical outcomes data now better documents associated risks.SummaryArmed with this updated information, we agree with the need for a national registry to better track patients with AAOCA. We submit that the risks of surgical management outweigh any benefits in the asymptomatic patient with anomalous right coronary artery, and expectant management should also be strongly considered even in asymptomatic patients with anomalous left coronary artery.

【 授权许可】

Unknown   
© Penalver et al.; licensee BioMed Central Ltd. 2012. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.