Safety and Efficacy of Surgical Correction of Anomalous Aortic Origin of Coronary Arteries: Experiences from two Tertiary Cardiac Centers.

Pregaldini, Fabio; Widenka, Hannah; Barghout, Mohamed; Gräni, Christoph; Czerny, Martin; Kari, Fabian; Chikvatia, Salome; Kadner, Alexander; Siepe, Matthias (2023). Safety and Efficacy of Surgical Correction of Anomalous Aortic Origin of Coronary Arteries: Experiences from two Tertiary Cardiac Centers. European journal of cardio-thoracic surgery, 63(5) Oxford University Press 10.1093/ejcts/ezad075

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OBJECTIVES

This study aims to describe the outcomes of surgical correction for anomalous aortic origin of coronary artery (AAOCA) with regard to symptom relief.

METHODS

We performed a retrospective multicentre study including surgical patients who underwent correction for AAOCA between 2009 and 2022. Patients who underwent concomitant cardiac procedures were also included. However, to analyze symptom relief we only assessed the subgroup of symptomatic patients who underwent isolated correction for AAOCA.

RESULTS

A total of 71 consecutive patients (median age 55, range 12-83) who underwent surgical correction for AAOCA were included in the study. Right-AAOCA was present in 56 patients (79%), left-AAOCA in 11 patients (15%), single coronary ostium AAOCA in 4 patients (6%). Coronary unroofing was performed in 72% of the patients, coronary reimplantation in 28% and an additional neo-ostium patchplasty in 13% of the patients. In 39% of the patients a concomitant cardiac procedure was performed. During follow-up, no cardiovascular-related death was observed. Three patients (4.2%) had a myocardial infarction and underwent postoperative coronary artery bypass grafting. Six patients (8.5%) needed postoperative temporary mechanical circulatory support. Among the 34 symptomatic patients who underwent isolated AAOCA correction, 70% were completely asymptomatic after surgery, 12% showed symptom improvement and no symptom improvement was observed in 18% of the patients (median follow-up 3.5 years, range 0.3-11.1).

CONCLUSIONS

Correction for AAOCA can be safely performed with or without concomitant cardiac procedures. Performing AAOCA correction leads to a significant improvement in symptoms for most patients.

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