This document provides expert consensus recommendations for the interventional management of adults with anomalous aortic origin of the coronary arteries to complement existing guidelines.
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.
“Today's review article is essential reading for anyone seeking a quick update on the literature surrounding AAOCA. With its iconography and schematic tables, it covers the diagnostic and therapeutic algorithms for these coronary anomalies comprehensively. However, it is worth emphasizing that a significant proportion of AAOCA cases involve multilevel obstructions, and failure to address all levels may result in persistent or recurrent ischemia.”
Gaudino et al. (Mon,) studied this question.