medigraphic.com
ISSN 2954-3835 (Electronic)
ISSN 2683-2828 (Print)

2026, Number 3

<< Back Next >>

Cardiovasc Metab Sci 2026; 37 (3)

Characterization of clinical and anatomical profile of patients with anomalous aortic origin of coronary arteries and their association with major cardiovascular outcomes: the experience of a Latin American third-level center

Sánchez-Amaya DJ, Portillo-Hernández JA, Godínez-Córdova LB, Rodríguez-Murillo NG, Rivera-Rodríguez DI, Suárez-Lara NN, Masso-Bueso JS, Gopar-Nieto R, Sierra-Lara Martínez JD, Posada-Martínez EL

Language: English
References: 16
Page: 120-129
PDF size: 1136.55 Kb.


ABSTRACT

Introduction: coronary artery abnormalities are a rare condition but one associated with a potentially serious outcome. Objectives: characterization of clinical and anatomical profiles of patients with Anomalous Aortic Origin of Coronary Arteries (AAOCA) and their association with any pre-specified Major Cardiovascular Events (MACE). Material and methods: a retrospective study was conducted among patients with AAOCA in a tertiary care center, from January 2000 to June 2022. We analyzed the association between clinical and anatomical characteristics of patients and pre-specified MACE (Acute Coronary Syndrome [ACS], surgical revascularization, or cardiovascular death). Results: fifty patients were included. The mean age was 52 ± 15 years, and most patients were male (68%). Systemic hypertension was the most frequent comorbidity (38%). Only five patients (10%) had congenital heart disease. ACS was the most frequent initial clinical presentation (42%). Most AAOCAs affected solely the right coronary artery (60%), and nearly half of all individuals (44%) had at least a high-risk characteristic. MACE was recorded in 14 patients (28%) with a median follow-up of 1,636 days [IQR 626-2,345]. Cumulative probability of MACE was higher in the high-risk group (log-rank p = 0.04). Conclusions: this study highlights the importance of identifying high-risk profiles in such patients, given their association with adverse outcomes.


REFERENCES

  1. Silva A, Joao Baptista M, Araújo E. Congenital coronaryartery anomalies. Rev Port Cardiol. 2018; 37 (4): 341-350. doi: 10.1016/j.repc.2017.09.015.

  2. Cheezum MK, Liberthson RR, Shah NR, Villines TC,O’gara PT, Landzberg MJ et al. Anomalous aortic originof a coronary artery from the inappropriate sinus ofvalsalva. J Am Coll Cardiol. 2017; 69 (12): 1592-1608.doi: 10.1016/j.jacc.2017.01.031.

  3. Bessiére F, Waldmann V, Combes N, Metton O, DibN, Mondésert B et al. Ventricular arrhythmias in adultswith congenital heart disease, Part I: JACC state-ofthe-art review. J Am Coll Cardiol. 2023; 82 (11):1108-1120. doi: 10.1016/j.jacc.2023.06.034.

  4. Hernández-Madrid A, Paul T, Abrams D, Aziz PF,Blom NA, Chen J et al. Arrhythmias in congenitalheart disease: a position paper of the European HeartRhythm Association (EHRA), Association for EuropeanPaediatric and Congenital Cardiology (AEPC), and theEuropean Society of Cardiology (ESC) Working Groupon grown-up congenital heart disease, endorsed byHRS, PACES, APHRS, and SOLAECE. Europace. 2018;20 (11): 1719-1720. doi: 10.1093/europace/eux380.

  5. Fierro-Renoy C, Romero ME, Padilla T, Calero MS,Benítez Saa F, Marlon-Aguirre AC. Prevalenciade anomalías coronarias congénitas detectadasmediante angiotomografía coronaria en el HospitalMetropolitano de Quito. Metro Cienc. 2024;32 (1): 20-28. doi: 10.47464/metrociencia/vol32/1/2024/20-28.

  6. Rodríguez-Urteaga ZI, Murillo-Pérez LE, Mendoza-Paulini A, Talledo-Paredes LS. Prevalence of coronaryanomalies detected by computed tomography at theInstituto Nacional Cardiovascular-INCOR. Arch PeruCardiol Cir Cardiovasc. 2022; 3 (3): 153-161. doi:10.47487/apcyccv.v3i3.233.

  7. Conte E, Marchetti D, Melotti E, Schillaci M, MushtaqS, Maffi V et al. Clinical and cardiac CT characteristicsof congenital coronary abnormalities occasionallydetected in a middle-aged population: a long-termfollow-up study. J Cardiovasc Comput Tomogr. 2024;18 (4): 375-382. doi: 10.1016/j.jcct.2024.04.002.

  8. Cheezum MK, Ghoshhajra B, Bittencourt MS, HultenEA, Bhatt A, Mousavi N et al. Anomalous origin ofthe coronary artery arising from the opposite sinus:prevalence and outcomes in patients undergoingcoronary CTA. Eur Heart J Cardiovasc Imaging. 2017;18 (2): 224-235. doi: 10.1093/ehjci/jev323.

  9. Padalino MA, Franchetti N, Hazekamp M, Sojak V,Carrel T, Frigiola A, et al. Surgery for Anomalous AorticOrigin of Coronary Arteries: A Multicentre Study fromthe European Congenital Heart Surgeons Association.Eur J Cardiothorac Surg. 2019; 56 (4): 696-703.doi:10.1093/ejcts/ezz080.

  10. Mazine A, Fernandes IM, Haller C, Hickey EJ.Anomalous origins of the coronary arteries: currentknowledge and future perspectives. Curr OpinCardiol. 2019; 34 (5): 543-551. doi: 10.1097/HCO.0000000000000663.

  11. Garg N, Tewari S, Kapoor A, Kumar Gupta D, Sinha N.Primary congenital anomalies of the coronary arteries:a coronary arteriographic study. Int J Cardiol. 2000;74: 39-46. doi: 10.1016/S0167-5273(00)00243-6.

  12. Grani C, Benz DC, Steffen DA, Clerc OF, Schmied C,Possner M, et al. Outcome in middle-aged individualswith anomalous origin of the coronary artery from theopposite sinus: a matched cohort study. Eur Heart J.2017; 38 (25): 2009-2016. doi: 10.1093/eurheartj/ehx046.

  13. Baumgartner H, de Backer J, Babu-Narayan SV, BudtsW, Chessa M, Diller GP et al. 2020 ESC Guidelines forthe management of adult congenital heart disease: the task force for the management of adult congenital heartdisease of the European Society of Cardiology (ESC).Endorsed by: Association for European Paediatric andCongenital Cardiology (AEPC), International Society forAdult Congenital Heart Disease (ISACHD). Eur HeartJ. 2021; 42 (6): 563-645. doi: 10.1093/eurheartj/ehaa554.

  14. Grani C, Buechel RR, Kaufmann PA, Kwong RY.Multimodality imaging in individuals with anomalouscoronary arteries. JACC Cardiovasc Imaging. 2017; 10(4): 471-481. doi: 10.1016/j.jcmg.2017.02.004.

  15. Layser RB, Savage MP, Halpern EJ. Anomalous coronaryarteries: analysis of clinical outcome based uponarterial course and surgical intervention in an adultpopulation. Acad Radiol. 2016; 23 (8): 1015-1023.doi: 10.1016/j.acra.2016.03.020.

  16. Ripley DP, Saha A, Teis A, Uddin A, Bijsterveld P, KidambiA et al. The distribution and prognosis of anomalouscoronary arteries identified by cardiovascular magneticresonance: 15-year experience from two tertiarycentres. J Cardiovasc Magn Reson. 2014; 16 (1): 34.doi:10.1186/1532-429X-16-34.




2020     |     www.medigraphic.com