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Diagnostic Yield of Non-Invasive Testing in Patients with Anomalous Aortic Origin of Coronary Arteries:A Multicentric Experience

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Congenital Heart Disease 2022年第4期17卷 375-385页

作者： Alberto Cipriani Pietro Bernardo Dall’Aglio Laura Mazzotta Domenico Sirico George Sarris Mark Hazekamp Thierry Carrel Alessandro Frigiola Vladimir Sojak Mauro Lo Rito Jurgen Horer Regine Roussin Julie Cleuziou Bart Meyns Jose Fragata Helena Telles Anastasios C.Polimenakos Katrien Francois Altin Veshti Jukka Salminen Alvaro Gonzalez Rocafort Matej Nosal Eleftherios Protopapas Roberto Tumbarello Patrizio Sarto Cinzia Pegoraro Raffaella Motta Giovanni Di Salvo Domenico Corrado Vladimiro LVida Massimo A.Padalino department of Cardio-Thoracic Vascular Sciences and Public HealthUniversity of PadovaPadovaItaly department of Woman and Child’s Health Pediatric CardiologyUniversity of PadovaPadovaItaly Athens Heart surgery Institute and Iaso Children’s hospital AthensGreece department for Cardiovascular surgery University Medical CenterLeidenThe Netherlands department for Cardiovascular surgery University Hospital BernBernSwitzerland department of Congenital Cardiac surgery IRCCS Policlinico San DonatoSan Donato MilaneseItaly department of Pediatric Cardiology and Congenital Heart Disease Hôpital Marie LannelongueUniversitéParis-SudLe Plessis-RobinsonFrance deutsch Herz Zentrum MunichGermany Katholieke Universiteit Leuven LeuvenBelgium cardiothoracic surgery hospital de santa marta rua LisbonPortugal department of Pediatric cardiothoracic surgery Children’s Hospital of GeorgiaGeorgiaUSA department of Cardiac surgery University Hospital GhentGhentBelgium Division of Cardiac surgery University Hospital Center of TiranaTiranaAlbania department of Pediatric Cardiac surgery Hospital for Children and AdolescentsUniversity of HelsinkiHelsinkiFinland Congenital Cardiac surgery department Hospital Universitario La PazMadridSpain department of Pediatric Cardiac surgery National Institute of Cardio-Vascular Diseases-Children’s Heart CenterBratislavaSlovakia Division of Pediatric Cardiology Ospedale BrotzuCagliariItaly Division of Sport Medicine Ospedale Ca’FoncelloTrevisoItaly department of Medicine Radiology ClinicUniversity of Padua Medical SchoolPadovaItaly

Background:Anomalous aortic origin of a coronary artery(AAOCA)is a congenital heart disease with a 0.3%−0.5%*** is challenging due to nonspecific clinical *** stratification and treatment are currently based on expert consensus and single-center case ***:demographical and clinical data of AAOCA patients from 17 tertiary-care centers were *** imaging studies(Bidimensional echocardiography,coronary computed tomography angiography[CCTA]were *** correlations with anomalous coronary course and origin were ***:Data from 239 patients(42%males,mean age 15 y)affected by AAOCA were collected;154 had AAOCA involving the right coronary artery(AAORCA),62 the left(AAOLCA),23 other anomalies.211(88%)presented with an inter-arterial *** electrocardiogram(ECG)was abnormal in 37(16%).AAOCA was detected by transthoracic echocardiography and CCTA in 53%and 92%of patients,*** of the patients reported cardiac symptoms(119/239;50%),mostly during exercise in 121/178(68%).An ischemic response was demonstrated in 37/106(35%)and 16/31(52%)of patients undergoing ECG stress test and stress-rest single positron emission cardiac *** with AAORCA,patients with AAOLCA presented more frequently with syncope(18%vs.5%,P=0.002),in particular when associated with inter-arterial course(22%vs.5%,P<0.001).Conclusion:Diagnosis of AAOCA is a clinical challenge due to nonspecific clinical presentations and low sensitivity of first-line cardiac screening *** seems to be strictly correlated to AAOLCA with inter-arterial course.

关键词： Anomalous coronary arteries congenital echocardiography coronary computed tomography angiography

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