Anomalous Origin of a Coronary Artery From the Opposite Sinus of Valsalva With an Interarterial Course: Clinical Profile and Approach to Management in the Pediatric Population
Open Access
- 12 September 2007
- journal article
- Published by Springer Science and Business Media LLC in Pediatric Cardiology
- Vol. 29 (1), 24-30
- https://doi.org/10.1007/s00246-007-9054-6
Abstract
An anomalous origin of a coronary artery from the opposite sinus of Valsalva with an interarterial course (interarterial coronary artery [IACA]) is a rare congenital anomaly associated with sudden cardiac death. The cardiac and surgical databases at a single pediatric institution were reviewed for a description of the clinical profiles and associated risk factors of this coronary anomaly. From 1994 to 2006, IACA was diagnosed for 31 patients with a median age of 6.2 years (range, birth to 16 years). The symptoms for 6 (19%) of the 10 patients (32%) presenting with symptoms were deemed to be cardiac in origin. The symptoms for the remaining 21 patients (68%) were incidental findings. Of the 31 patients, 29 (94%) had normal resting electrocardiograms (ECG). A total of 17 patients underwent dobutamine stress echo. None had wall motion abnormalities, but two had ECG changes indicating ischemia, and 4 had abnormal coronary flow, as detected by Doppler echocardiography. Seven patients, with either acute symptoms or testing suggestive of ischemia, underwent surgery. All seven had an interarterial left main coronary artery. There was one cardiac-related death. No sudden death was found in either the surgery or nonsurgery group during the mean follow-up period of 23 and 58 months, respectively. Whether surgical intervention modifies the natural history of the anomaly or not remains to be determined.Keywords
This publication has 27 references indexed in Scilit:
- Anomalous Coronary Arteries: A Multicenter Pediatric Autopsy StudyPediatric Pathology, 1994
- Prospective echocardiographic screening for coronary artery anomalies in 1,360 elite competitive athletesThe American Journal of Cardiology, 1993
- Congenital malformations of the coronary arteries: The Texas Heart Institute experienceThe Annals of Thoracic Surgery, 1992
- Anomalous origin of either the right or left main coronary artery from the aorta with subsequent coursing between aorta and pulmonary trunk: Analysis of 32 necropsy casesThe American Journal of Cardiology, 1988
- Origin of the right coronary artery from the left sinus of Valsalva and its functional consequences: Analysis of 10 necropsy patientsThe American Journal of Cardiology, 1982
- Aberrant coronary artery origin from the aorta. Report of 18 patients, review of literature and delineation of natural history and management.Circulation, 1979
- Clinical, angiographic, and hemodynamic findings in patients with anomalous origin of the coronary arteries.Circulation, 1976
- Sudden Death as a Complication of Anomalous Left Coronary Origin From the Anterior Sinus of ValsalvaCirculation, 1974
- Fatal myocardial infarction in an 11 year old boy associated with a unique coronary artery anomalyThe American Journal of Cardiology, 1967
- Anomalies of the Coronary Arteries and their Clinical SignificanceCirculation, 1956