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Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study

2019-09-15Journal article Open access
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dc.contributor.authorPadalino, M
dc.contributor.authorFranchetti, N
dc.contributor.authorSarris, GE
dc.contributor.authorHazekamp, M
dc.contributor.authorCarrel, T
dc.contributor.authorFrigiola, A
dc.contributor.authorHorer, J
dc.contributor.authorRoussin, R
dc.contributor.authorCleuziou, J
dc.contributor.authorMeyns, B
dc.contributor.authorFragata, J
dc.contributor.authorTelles, H
dc.contributor.authorPolimenakos, A
dc.contributor.authorFrancois, K
dc.contributor.authorVeshti, A
dc.contributor.authorSalminen, J
dc.contributor.authorRocafort, A
dc.contributor.authorNosal, M
dc.contributor.authorVedovelli, L
dc.contributor.authorProtopapas, E
dc.contributor.authorTumbarello, R
dc.contributor.authorMerola, A
dc.contributor.authorPegoraro, C
dc.contributor.authorMotta, R
dc.contributor.authorBoccuzzo, G
dc.contributor.authorSojak, V
dc.contributor.authorRito, M
dc.contributor.authorCaldaroni, F
dc.contributor.authorCorrado, D
dc.contributor.authorBasso, C
dc.contributor.authorStellin, G
dc.date.accessioned2019-11-08T16:24:24Z
dc.date.available2019-11-08T16:24:24Z
dc.date.issued2019-09-15
dc.description.abstractBACKGROUND: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. METHODS: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. RESULTS: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p < 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p < 0.001). CONCLUSIONS: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal life. Since the long term-risk of sudden cardiac death is still unknown, we currently recommend accurate long term surveillance in all patients with AAOCA.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationInt J Cardiol. 2019 Sep 15;291:189-193.pt_PT
dc.identifier.doi10.1016/j.ijcard.2019.02.007pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3348
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectHSM CCTpt_PT
dc.subjectCoronary Vessel Anomalies / diagnosispt_PT
dc.subjectCoronary Vessel Anomalies / therapypt_PT
dc.subjectDisease Managementpt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectInternationalitypt_PT
dc.subjectLongitudinal Studies
dc.subjectRetrospective Studies
dc.subjectAdolescent
dc.subjectAdult
dc.subjectChild
dc.subjectFemale
dc.subjectMale
dc.subjectHumans
dc.subjectMiddle Aged
dc.subjectYoung Adult
dc.titleAnomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Studypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage193pt_PT
oaire.citation.startPage189pt_PT
oaire.citation.titleInternational Journal of Cardiologypt_PT
oaire.citation.volume291pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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