Surgical repair of anomalous aortic origin of coronary artery in adults.
Asian Cardiovasc Thorac Ann
; 29(1): 51-58, 2021 Jan.
Article
de En
| MEDLINE
| ID: mdl-32903023
ABSTRACT
Anomalous aortic origin of a coronary artery is a congenital abnormality of the origin or course of a coronary artery that arises from the aorta. The surgical treatment of this anomaly is highly variable and controversial and is achieved by implementing elaborate techniques of anatomic repair or by simple coronary artery bypass grafting. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Two independent reviewers determined whether studies met the inclusion criteria. Eligible papers were published in English, clinical studies describing surgical repair of anomalous aortic origin of a coronary artery including coronary artery bypass in adults, and enrolled >5 patients. In the absence of multicentre trials, 7 single-center retrospective series were included, which demonstrated comparable short- and midterm outcomes of anatomic repair and coronary artery bypass in adults with anomalous aortic origin of a coronary artery. Coronary unroofing was the preferred technique when the anomalous artery has an intramural component, but there is a risk of aortic insufficiency. Anatomic repair is technically demanding and should be carried out in experienced centers. Coronary artery bypass with internal thoracic artery or vein grafts is technically straightforward with low operative risk and comparable midterm outcomes, however, long-term outcomes are unknown. Coronary artery bypass grafting is the technique of choice for older patients, in those with concomitant coronary artery disease, as a bailout procedure for failed anatomic repair, or in centers without experience in anatomic repair for anomalous aortic origin of a coronary artery.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Aorte
/
Pontage aortocoronarien
/
Anomalies congénitales des vaisseaux coronaires
/
Vaisseaux coronaires
Type d'étude:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limites:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Langue:
En
Journal:
Asian Cardiovasc Thorac Ann
Sujet du journal:
ANGIOLOGIA
/
CARDIOLOGIA
Année:
2021
Type de document:
Article
Pays d'affiliation:
Grèce