Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review

Mario Gaudino¹, Antonino Di Franco², Eloisa Arbustini³, Emile Bacha⁴, Eric R Bates⁵, Duke E Cameron⁶, Davide Cao⁷, Tirone E David⁸, Ruggero De Paulis⁹, Ismail El-Hamamsy¹⁰, Kanwal M Farooqi¹¹, Leonard N Girardi², Christoph Gräni¹², Jonathan D Kochav¹³, Silvana Molossi¹⁴, John D Puskas¹⁰, Sunil V Rao¹⁵, Sigrid Sandner¹⁶, James Tatoulis¹⁷, Quynh A Truong¹⁸, Jonathan W Weinsaft¹⁹, Daniel Zimpfer²⁰, Carlos M Mery²¹

Affiliations

¹ Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA. Electronic address: mfg9004@med.cornell.edu.
² Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
³ Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, IRCCS and Polyclinic San Matteo Foundation, Pavia, Italy.
⁴ Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York, USA.
⁵ Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁶ Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁷ The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
⁸ Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
⁹ Department of Cardiac Surgery, European Hospital, Rome, Italy; UniCamillus University, Rome, Italy.
¹⁰ Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹¹ Division of Pediatric Cardiology, New York-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA.
¹² Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹³ Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA.
¹⁴ Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
¹⁵ Division of Interventional Cardiology, NYU Langone Health, New York, New York, USA.
¹⁶ Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
¹⁷ Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.
¹⁸ Department of Radiology, New York Presbyterian, Weill Cornell Medicine, New York, New York, USA.
¹⁹ Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
²⁰ Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
²¹ Texas Center for Pediatric and Congenital Heart Disease, Dell Medical School at The University of Texas at Austin/Dell Children's Medical Center, Austin, Texas, USA.

PMID: 37855757
DOI: 10.1016/j.jacc.2023.08.012

Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review

Mario Gaudino et al. J Am Coll Cardiol. 2023.

. 2023 Nov 21;82(21):2034-2053.

doi: 10.1016/j.jacc.2023.08.012. Epub 2023 Oct 16.

Authors

Affiliations

¹ Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA. Electronic address: mfg9004@med.cornell.edu.
² Department of Cardiothoracic Surgery, Weill Cornell Medicine, New York, New York, USA.
³ Transplant Research Area and Centre for Inherited Cardiovascular Diseases, Scientific Department, IRCCS and Polyclinic San Matteo Foundation, Pavia, Italy.
⁴ Division of Cardiac, Thoracic, and Vascular Surgery, Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York, USA.
⁵ Cardiovascular Center, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
⁶ Division of Cardiac Surgery, Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
⁷ The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Biomedical Sciences, Humanitas University, Milan, Italy.
⁸ Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
⁹ Department of Cardiac Surgery, European Hospital, Rome, Italy; UniCamillus University, Rome, Italy.
¹⁰ Department of Cardiovascular Surgery, Mount Sinai Hospital and Icahn School of Medicine at Mount Sinai, New York, New York, USA.
¹¹ Division of Pediatric Cardiology, New York-Presbyterian, Columbia University Irving Medical Center, New York, New York, USA.
¹² Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
¹³ Division of Cardiology, Columbia University Irving Medical Center, New York, New York, USA.
¹⁴ Division of Pediatric Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.
¹⁵ Division of Interventional Cardiology, NYU Langone Health, New York, New York, USA.
¹⁶ Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
¹⁷ Department of Cardiothoracic Surgery, Royal Melbourne Hospital, University of Melbourne, Melbourne, Victoria, Australia.
¹⁸ Department of Radiology, New York Presbyterian, Weill Cornell Medicine, New York, New York, USA.
¹⁹ Greenberg Cardiology Division, Department of Medicine, Weill Cornell Medical College, New York, New York, USA.
²⁰ Division of Cardiac Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.
²¹ Texas Center for Pediatric and Congenital Heart Disease, Dell Medical School at The University of Texas at Austin/Dell Children's Medical Center, Austin, Texas, USA.

PMID: 37855757
DOI: 10.1016/j.jacc.2023.08.012

Abstract

As a result of increasing adoption of imaging screening, the number of adult patients with a diagnosis of anomalous aortic origin of the coronary arteries (AAOCA) has grown in recent years. Existing guidelines provide a framework for management and treatment, but patients with AAOCA present with a wide range of anomalies and symptoms that make general recommendations of limited applicability. In particular, a large spectrum of interventions can be used for treatment, and there is no consensus on the optimal approach to be used. In this paper, a multidisciplinary group of clinical and interventional cardiologists and cardiac surgeons performed a systematic review and critical evaluation of the available evidence on the interventional treatment of AAOCA in adult patients. Using a structured Delphi process, the group agreed on expert recommendations that are intended to complement existing clinical practice guidelines.

Keywords: AAOCA; anomalous origin coronary arteries; coronary anomaly; treatment.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Di Franco has served as a consultant for Novo Nordisk and Servier; and has served as an advisory board member for Scharper. Dr Gräni has received funding from the Swiss National Science Foundation, InnoSuisse, the GAMBIT foundation, and the CAIM foundation, outside of the submitted work. Dr Weinsaft has received speaker fees from GE Healthcare; and has served as a consultant for Bitterroot Bio. Dr Zimpfer has served as an advisor and advisory board member for Medtronic, Abbott, Berlin Heart, Abiomed, Fineheart, and Corewave; has served on the Speakers Bureau for Medtronic, Abbott, Berlin Heart, Abiomed, Corzym, and Edwards Lifesciences; and has received research grants and travel support from Medtronic, Abbott, Berlin Heart, Abiomed, Corzym, and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review

Affiliations

Management of Adults With Anomalous Aortic Origin of the Coronary Arteries: State-of-the-Art Review

Authors

Affiliations

Abstract

Conflict of interest statement

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Research Materials