Surgery for Anomalous Aortic Origin of Coronary Arteries: Technical Safeguards and Pitfalls

Massimo A Padalino; Anusha Jegatheeswaran; David Blitzer; Gabriella Ricciardi; Alvise Guariento

doi:10.3389/fcvm.2021.626108

Surgery for Anomalous Aortic Origin of Coronary Arteries: Technical Safeguards and Pitfalls

Front Cardiovasc Med. 2021 May 12:8:626108. doi: 10.3389/fcvm.2021.626108. eCollection 2021.

Authors

Massimo A Padalino¹, Anusha Jegatheeswaran², David Blitzer³, Gabriella Ricciardi⁴, Alvise Guariento^{1

2}

Affiliations

¹ Section of Pediatric and Congenital Cardiac Surgery, Department of Cardio-Thoracic and Vascular Sciences, and Public Health, University of Padova, Medical School, Padua, Italy.
² Division of Cardiovascular Surgery, Department of Surgery, Hospital for Sick Children, Toronto, ON, Canada.
³ Department of Surgery, New York Presbyterian Hospital, Columbia University, New York, NY, United States.
⁴ Department of Cardiac Surgery, Leiden Universitair Medisch Centrum, Leiden, Netherlands.

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.

Keywords: anomalous coronary arteries; outcomes; pitfalls; surgery; techniques.

Publication types

Review