Surgery for anomalous aortic origin of coronary arteries

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Padalino , M A , Franchetti , N , Hazekamp , M , Sojak , V , Carrel , T , Frigiola , A , Lo Rito , M , Horer , J , Roussin , R , Cleuziou , J , Meyns , B , Fragata , J , Telles , H , Polimenakos , A C , Francois , K , Veshti , A , Salminen , J , Rocafort , A G , Nosal , M , Vedovelli , L , Guariento , A , Vida , V L , Sarris , G E , Boccuzzo , G & Stellin , G 2019 , ' Surgery for anomalous aortic origin of coronary arteries : a multicentre study from the European Congenital Heart Surgeons Association ' , European Journal of Cardio-Thoracic Surgery , vol. 56 , no. 4 , pp. 696-703 . https://doi.org/10.1093/ejcts/ezz080

Title: Surgery for anomalous aortic origin of coronary arteries;
a multicentre study from the European Congenital Heart Surgeons Association
Author: Padalino, Massimo A.; Franchetti, Nicola; Hazekamp, Mark; Sojak, Vladimir; Carrel, Thierry; Frigiola, Alessandro; Lo Rito, Mauro; Horer, Jurgen; Roussin, Regine; Cleuziou, Julie; Meyns, Bart; Fragata, Jose; Telles, Helena; Polimenakos, Anastasios C.; Francois, Katrien; Veshti, Altin; Salminen, Jukka; Rocafort, Alvaro Gonzalez; Nosal, Matej; Vedovelli, Luca; Guariento, Alvise; Vida, Vladimiro L.; Sarris, George E.; Boccuzzo, Giovanna; Stellin, Giovanni
Contributor: University of Helsinki, HUS Children and Adolescents
Date: 2019-10
Number of pages: 8
Belongs to series: European Journal of Cardio-Thoracic Surgery
ISSN: 1010-7940
URI: http://hdl.handle.net/10138/306839
Abstract: OBJECTIVES: We sought to describe early and late outcomes in a large surgical series of patients with anomalous aortic origin of coronary arteries. METHODS: We performed a retrospective multicentre study including surgical patients with anomalous aortic origin of coronary arteries since 1991. Patients with isolated high coronary takeoff and associated major congenital heart disease were excluded. RESULTS: We collected 156 surgical patients (median age 39.5 years, interquartile range 15-53) affected by anomalous right (67.9%), anomalous left (22.4%) and other anatomical abnormalities (9.6%). An interarterial course occurred in 86.5%, an intramural course in 62.8% and symptoms in 85.9%. The operations included coronary unroofing (56.4%), reimplantation (19.2%), coronary bypass graft (15.4%) and other (9.0%). Two patients with preoperative cardiac failure died postoperatively (1.3%). All survivors were discharged home in good clinical condition. At a median follow-up of 2 years (interquartile range 1-5, 88.5% complete), there were 3 deaths (2.2%), 9 reinterventions in 8 patients (5 interventional, 3 surgical); 91.2% are in New York Heart Association functional class CONCLUSIONS: Surgical repair of anomalous aortic origin of coronary arteries is effective and has few complications. Unroofing and coronary reimplantation are safe and are the most common procedures. The occurrence of late adverse events is not negligible, and long-term surveillance is mandatory. Most young athletes can return to an unrestrained lifestyle.
Subject: Cardiac surgery
Anomalous coronary arteries
Congenital
Outcomes
SUDDEN CARDIAC DEATH
SURGICAL REPAIR
TASK-FORCE
SINUS
MANAGEMENT
BYPASS
3126 Surgery, anesthesiology, intensive care, radiology
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