scholarly journals Hemodynamic Relevance of Anomalous Coronary Arteries Originating From the Opposite Sinus of Valsalva-In Search of the Evidence

2021 ◽  
Vol 7 ◽  
Author(s):  
Marius Reto Bigler ◽  
Afreed Ashraf ◽  
Christian Seiler ◽  
Fabien Praz ◽  
Yasushi Ueki ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Coronary Arteries ◽  
Young Patients ◽  
Sinus Of Valsalva ◽  
Strenuous Physical Activity ◽  
Diagnostic Modalities ◽  
Diagnostic Work ◽  
Evidence Based Guidelines ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Coronary artery anomalies (CAA) represent a heterogeneous group of congenital disorders of the arterial coronary circulation, defined by an anomalous origin of the coronary ostium and/or vessel course. Of particular interest are anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). The interarterial variants (with the anomalous vessel situated between the great arteries) are historically called “malignant,” based on an anticipated higher risk for myocardial ischemia and sudden cardiac death (SCD), especially affecting young patients during strenuous physical activity. However, the interarterial course itself may not be the predominant cause of ischemia, but rather represents a surrogate for other ischemia-associated anatomical high-risk features. As the exact pathophysiology of ACAOS is not well-understood, there is a lack of evidence-based guidelines addressing optimal diagnostic work-up, downstream testing, sports counseling, and therapeutic options in patients with ACAOS. Therefore, treating physicians are often left with uncertainty regarding the clinical management of affected patients. This review focuses on the pathophysiologic consequences of ACAOS on myocardial ischemia and discusses the concept of the interplay between fixed and dynamic coronary stenosis. Further, we discuss the advantages and limitations of the different diagnostic modalities and give an outlook by highlighting the gaps of knowledge in the assessment of such anomalies.

Surgical Repair of Anomalous Coronary Arteries Arising from the Opposite Sinus of Valsalva in Infants and Children

2009 ◽  
Vol 24 (4) ◽  
pp. 466-469 ◽  
Author(s):  
Chawki elZein ◽  
Ziad Hanhan ◽  
Malek Massad ◽  
Mary-Jane Barth ◽  
Sunthorn Muangmingsuk ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Surgical Repair ◽  
Infants And Children ◽  
Sinus Of Valsalva ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries ◽  
In Infants And Children

Six-month success of intracoronary stenting for anomalous coronary arteries associated with myocardial ischemia

2000 ◽  
Vol 86 (5) ◽  
pp. 580-582 ◽  
Author(s):  
Andrew J Doorey ◽  
Michael J Pasquale ◽  
James F Lally ◽  
Gary S Mintz ◽  
Erik Marshall ◽  
...  
Keyword(s):  
Myocardial Ischemia ◽  
Coronary Arteries ◽  
Intracoronary Stenting ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

scholarly journals Anomalous Origin of All Coronary Arteries from Right Sinus of Valsalva

2020 ◽  
Vol 47 (2) ◽  
pp. 170-172
Author(s):  
Harini Bollempalli ◽  
Vijay G. Divakaran ◽  
Andrew C. Kontak ◽  
Patricia C. Lee
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Sinus Of Valsalva ◽  
Exertional Dyspnea ◽  
Atherosclerotic Stenosis ◽  
Obtuse Marginal Branch ◽  
Obtuse Marginal ◽  
The Right ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Anomalous coronary arteries are rare and often incidental findings. Most variants are benign. We present the case of a 75-year-old man with exertional dyspnea in whom the left anterior descending coronary artery arose from the right sinus of Valsalva, and the left circumflex coronary artery originated from the distal right coronary artery and supplied the obtuse marginal branch. No arteries originated from the left sinus of Valsalva. The patient was prescribed optimal medical therapy for atherosclerotic stenosis in his ramus intermedius. His symptoms were stable 3 years later.

Anomalous Coronary Arteries Originating in the Contralateral Sinus of Valsalva: Registry of Thirteen Spanish Hospitals (RACES)

2006 ◽  
Vol 59 (6) ◽  
pp. 620-623
Author(s):  
Roberto Barriales-Villa ◽  
César Morís ◽  
Juan C. Sanmartín ◽  
Eduard Fernández ◽  
Fernando Pajín ◽  
...  
Keyword(s):  
Coronary Arteries ◽  
Sinus Of Valsalva ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Die Koronaranomalie – vom Zufallsbefund zum plötzlichen Herztod?

2016 ◽  
Vol 73 (12) ◽  
pp. 766-770
Author(s):  
Dominik C. Benz ◽  
Philipp A. Kaufmann
Keyword(s):  
Koronare Herzkrankheit ◽  
Coronary Arteries ◽  
Single Photon ◽  
Wird Eine ◽  
Sinus Of Valsalva ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries

Zusammenfassung. Koronaranomalien sind mit dem plötzlichen Herztod assoziiert. Manchmal ist er der erste und einzige Hinweis für eine Koronaranomalie. Aufgrund der potentiell letalen Folgen wird bei jungen Patienten mit typischen Thoraxschmerzen oder einer Synkope beim Sport versucht, eine Koronaranomalie mittels kardialer Bildgebung auszuschliessen. Viel häufiger ist die Koronaranomalie aber ein Zufallsbefund in der Abklärung von Patienten mit Verdacht auf eine koronare Herzkrankheit oder in der Vorbereitung von Patienten für eine Pulmonalvenenisolation mittels der Herz-CT-Untersuchung. Die Prävalenz der Koronaranomalie liegt an unserem Zentrum bei 2.6 %. Einige von ihnen – wie die Koronaranomalien, die dem gegenüberliegenden Sinus Valsalva entspringen (sogenannte ACAOS, anomalous coronary arteries originating from the opposite site of the sinus of Valsalva), Koronarfisteln oder das Bland-White-Garland Syndrom – gehen mit einem erhöhten kardiovaskulären Risiko einher. Eine weiterführende Abklärung der hämodynamischen Relevanz der Koronaranomalie ist in diesen Fällen empfohlen – unabhängig davon, ob es sich um die Verdachtsdiagnose oder einen Zufallsbefund handelt. Idealerweise wird eine Durchblutungsuntersuchung mittels der Single-Photon-Emissions-Computertomographie (SPECT) oder der Positronen-Emissions-Tomographie (PET) durchgeführt, die eine Fusion mit der Herz-CT-Untersuchung erlauben. In der Hybridbildgebung kann die Koronaranomalie dann einem minderdurchbluteten Areal zugeordnet werden und von einer allenfalls begleitenden koronaren Herzkrankheit abgegrenzt werden. Das Alter des Patienten, die klinische Präsentation und der Befund der Bildgebung sind entscheidend für das weitere therapeutische Vorgehen. Bei fehlenden prospektiv-randomisierten Studien sind die Therapie-Empfehlungen allerdings meist nur auf Expertenmeinungen gestützt und sollen im Einzelfall eingehend mit dem Patienten und in der kardiologisch-thoraxschirurgischen Konferenz besprochen werden.

Sports Behavior in Middle-Aged Individuals with Anomalous Coronary Artery from the Opposite Sinus of Valsalva

Cardiology ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 222-230 ◽  
Author(s):  
Christoph Gräni ◽  
Dominik C. Benz ◽  
Dominik A. Steffen ◽  
Andreas A. Giannopoulos ◽  
Michael Messerli ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Surgical Correction ◽  
Anomalous Coronary Artery ◽  
Sinus Of Valsalva ◽  
Middle Aged ◽  
Anomalous Coronary ◽  
Anomalous Coronary Arteries ◽  
Sports Activities

Objectives: Recommendations regarding sports restriction are lacking for middle-aged athletes with anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS). Methods: Sixty-three patients with ACAOS were subdivided into ACAOS with (n = 38) or without (n = 25) an interarterial course (IAC). Sports behavior, either competitive (COMP) or recreational (REC), was evaluated at the time of diagnosis and after a median follow-up of 4.2 years. Results: Mean age was 56 ± 11 years and 48 (76.2%) patients were engaged in sports. Three individuals (4.8%) were surgically corrected after diagnosis. Thirty-eight (60.3%) patients were aware of their diagnosis at follow-up and 12 (19.0%) were counseled by their physician about sports restrictions. Sports behavior at the time of diagnosis and at follow-up did not differ significantly, neither in patients engaged in COMP (17.5 vs. 12.7%, p = 0.619) nor those engaged in REC (58.7 vs. 61.9%, p = 0.856). Sport-related symptoms were not significantly different between ACAOS patients with and without IAC. No athlete had died at follow-up. Conclusions: The majority of middle-aged individuals with ACAOS were involved in sports activities at the time of diagnosis and at follow-up. Awareness and counseling about ACAOS diagnosis had no significant effect on sports behavior. IAC did not have an impact on sport-related symptoms, and outcomes were favorable in all athletes, regardless of surgical correction.

Sign in / Sign up

Export Citation Format

Share Document