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A Survey on the Management of Anomalous Aortic Origins of the Coronary Arteries.
Rauf, Hareem; Zhang, Xiao; Hokanson, John S.
Afiliação
  • Rauf H; Undergraduate Research Scholars Program, University of Wisconsin, Madison, WI, USA.
  • Zhang X; Division of Pediatric Cardiology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
  • Hokanson JS; Division of Pediatric Cardiology, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. jhokanson@wisc.edu.
Pediatr Cardiol ; 2023 Jun 30.
Article em En | MEDLINE | ID: mdl-37389591
The management of patients with an anomalous aortic origin of a coronary artery (AAOCA) remains controversial despite the publication of the 2017 American Association for Thoracic Surgery (AATS) expert guidelines. We surveyed the American Academy of Pediatrics Section on Cardiology and Cardiac Surgery and the Pediheart.net online community regarding their care of patients with anomalous origins of the right or left coronary from the opposite cusp with inter-arterial courses and compared them to the AATS guidelines. We received 111 complete responses. Four notable variations from the AATS recommendations were identified. Respondents were more likely to use ECG exercise testing than the stress imaging recommended in the AATS guidelines. For a 16-year-old with AAOCA, recommendations for surgery generally followed the AATS guidelines. However, for asymptomatic left AAOCA without signs of ischemia on stress imaging, only 69.4% felt surgery was appropriate or somewhat appropriate. In the setting of a 16-year-old with right AAOCA free from signs or symptoms of ischemia, respondents were more likely to recommend surgery if the patient was a competitive athlete, a topic not directly addressed in the AATS guidelines. After surgical treatment of AAOCA, only 24% of respondents recommended lifelong antiplatelet therapy despite recommendations for this in the AATS guidelines. Respondents recommendations were generally consistent with the 2017 AATS guidelines but with important variations in the use of stress imaging, indications for surgery in asymptomatic left AAOCA, the impact of identification as a competitive athlete and duration of postoperative antiplatelet therapy.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Guideline / Qualitative_research Idioma: En Revista: Pediatr Cardiol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Guideline / Qualitative_research Idioma: En Revista: Pediatr Cardiol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: Estados Unidos