Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/3348 |
Resumo: | BACKGROUND: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. METHODS: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. RESULTS: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p < 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p < 0.001). CONCLUSIONS: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal life. Since the long term-risk of sudden cardiac death is still unknown, we currently recommend accurate long term surveillance in all patients with AAOCA. |
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Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter StudyHSM CCTCoronary Vessel Anomalies / diagnosisCoronary Vessel Anomalies / therapyDisease ManagementFollow-Up StudiesInternationalityLongitudinal StudiesRetrospective StudiesAdolescentAdultChildFemaleMaleHumansMiddle AgedYoung AdultBACKGROUND: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. METHODS: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. RESULTS: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p < 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p < 0.001). CONCLUSIONS: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal life. Since the long term-risk of sudden cardiac death is still unknown, we currently recommend accurate long term surveillance in all patients with AAOCA.ElsevierRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEPadalino, MFranchetti, NSarris, GEHazekamp, MCarrel, TFrigiola, AHorer, JRoussin, RCleuziou, JMeyns, BFragata, JTelles, HPolimenakos, AFrancois, KVeshti, ASalminen, JRocafort, ANosal, MVedovelli, LProtopapas, ETumbarello, RMerola, APegoraro, CMotta, RBoccuzzo, GSojak, VRito, MCaldaroni, FCorrado, DBasso, CStellin, G2019-11-08T16:24:24Z2019-09-152019-09-15T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/3348engInt J Cardiol. 2019 Sep 15;291:189-193.10.1016/j.ijcard.2019.02.007info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:42:31Zoai:repositorio.chlc.min-saude.pt:10400.17/3348Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:39.863561Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
title |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
spellingShingle |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study Padalino, M HSM CCT Coronary Vessel Anomalies / diagnosis Coronary Vessel Anomalies / therapy Disease Management Follow-Up Studies Internationality Longitudinal Studies Retrospective Studies Adolescent Adult Child Female Male Humans Middle Aged Young Adult |
title_short |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
title_full |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
title_fullStr |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
title_full_unstemmed |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
title_sort |
Anomalous Aortic Origin of Coronary Arteries: Early Results on Clinical Management from an International Multicenter Study |
author |
Padalino, M |
author_facet |
Padalino, M Franchetti, N Sarris, GE Hazekamp, M Carrel, T Frigiola, A Horer, J Roussin, R Cleuziou, J Meyns, B Fragata, J Telles, H Polimenakos, A Francois, K Veshti, A Salminen, J Rocafort, A Nosal, M Vedovelli, L Protopapas, E Tumbarello, R Merola, A Pegoraro, C Motta, R Boccuzzo, G Sojak, V Rito, M Caldaroni, F Corrado, D Basso, C Stellin, G |
author_role |
author |
author2 |
Franchetti, N Sarris, GE Hazekamp, M Carrel, T Frigiola, A Horer, J Roussin, R Cleuziou, J Meyns, B Fragata, J Telles, H Polimenakos, A Francois, K Veshti, A Salminen, J Rocafort, A Nosal, M Vedovelli, L Protopapas, E Tumbarello, R Merola, A Pegoraro, C Motta, R Boccuzzo, G Sojak, V Rito, M Caldaroni, F Corrado, D Basso, C Stellin, G |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Padalino, M Franchetti, N Sarris, GE Hazekamp, M Carrel, T Frigiola, A Horer, J Roussin, R Cleuziou, J Meyns, B Fragata, J Telles, H Polimenakos, A Francois, K Veshti, A Salminen, J Rocafort, A Nosal, M Vedovelli, L Protopapas, E Tumbarello, R Merola, A Pegoraro, C Motta, R Boccuzzo, G Sojak, V Rito, M Caldaroni, F Corrado, D Basso, C Stellin, G |
dc.subject.por.fl_str_mv |
HSM CCT Coronary Vessel Anomalies / diagnosis Coronary Vessel Anomalies / therapy Disease Management Follow-Up Studies Internationality Longitudinal Studies Retrospective Studies Adolescent Adult Child Female Male Humans Middle Aged Young Adult |
topic |
HSM CCT Coronary Vessel Anomalies / diagnosis Coronary Vessel Anomalies / therapy Disease Management Follow-Up Studies Internationality Longitudinal Studies Retrospective Studies Adolescent Adult Child Female Male Humans Middle Aged Young Adult |
description |
BACKGROUND: Anomalous aortic origin of coronary arteries (AAOCA) is a rare abnormality, whose optimal management is still undefined. We describe early outcomes in patients treated with different management strategies. METHODS: This is a retrospective clinical multicenter study including patients with AAOCA, undergoing or not surgical treatment. Patients with isolated high coronary take off and associated major congenital heart disease were excluded. Preoperative, intraoperative, anatomical and postoperative data were retrieved from a common database. RESULTS: Among 217 patients, 156 underwent Surgical repair (median age 39 years, IQR: 15-53), while 61 were Medical (median age 15 years, IQR: 8-52), in whom AAOCA was incidentally diagnosed during screening or clinical evaluations. Surgical patients were more often symptomatic when compared to medical ones (87.2% vs 44.3%, p < 0.001). Coronary unroofing was the most frequent procedure (56.4%). Operative mortality was 1.3% (2 patients with preoperative severe heart failure). At a median follow up of 18 months (range 0.1-23 years), 89.9% of survivors are in NYHA ≤ II, while only 3 elderly surgical patients died late. Return to sport activity was significantly higher in Surgical patients (48.1% vs 18.2%, p < 0.001). CONCLUSIONS: Surgery for AAOCA is safe and with low morbidity. When compared to Medical patients, who remain on exercise restriction and medical therapy, surgical patients have a benefit in terms of symptoms and return to normal life. Since the long term-risk of sudden cardiac death is still unknown, we currently recommend accurate long term surveillance in all patients with AAOCA. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-11-08T16:24:24Z 2019-09-15 2019-09-15T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/3348 |
url |
http://hdl.handle.net/10400.17/3348 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Int J Cardiol. 2019 Sep 15;291:189-193. 10.1016/j.ijcard.2019.02.007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Elsevier |
publisher.none.fl_str_mv |
Elsevier |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131302674300928 |