Features associated with myocardial ischemia in anomalous aortic origin of a coronary artery: A Congenital Heart Surgeons' Society study

We sought to determine anatomic features associated with evidence of myocardial ischemia and sudden cardiac events (arrest or death) for patients with anomalous aortic origin of a coronary artery. We enrolled 560 patients, less than or equal to 30 years, at diagnosis from 40 institutions. Ischemia w...

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Bibliographic Details
Published in:The Journal of thoracic and cardiovascular surgery 2019-09, Vol.158 (3), p.822-834.e3
Main Authors: Jegatheeswaran, Anusha, Devlin, Paul J., McCrindle, Brian W., Williams, William G., Jacobs, Marshall L., Blackstone, Eugene H., DeCampli, William M., Caldarone, Christopher A., Gaynor, J. William, Kirklin, James K., Lorber, Richard O., Mery, Carlos M., St. Louis, James D., Molossi, Silvana, Brothers, Julie A.
Format: Article
Language:English
Subjects:
Adolescent
Adult
anomalous aortic origin of a coronary artery
Cardiac Imaging Techniques
Child
congenital heart disease
Death, Sudden, Cardiac - etiology
epidemiology
Female
Heart Arrest - etiology
Heart Arrest - mortality
Humans
ischemia
Male
Myocardial Ischemia - diagnostic imaging
Myocardial Ischemia - etiology
Myocardial Ischemia - mortality
North America
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Vascular Malformations - complications
Vascular Malformations - diagnostic imaging
Vascular Malformations - mortality
Young Adult
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Summary:We sought to determine anatomic features associated with evidence of myocardial ischemia and sudden cardiac events (arrest or death) for patients with anomalous aortic origin of a coronary artery. We enrolled 560 patients, less than or equal to 30 years, at diagnosis from 40 institutions. Ischemia was defined as the presence of exertional syncope, a sudden cardiac event (arrest/death), or abnormal investigation results. Data on detailed anatomic features were abstracted from echocardiography, computed tomography, magnetic resonance imaging, operative, and/or surgeon-completed reports. There were 236 patients with negative ischemia test results, and 49 with evidence of ischemia (including 18 who presented with a sudden cardiac event); 275 asymptomatic patients who had not undergone provocative ischemia testing were excluded from primary analyses. Patients with ischemia (vs without), were more likely to have left anomalous coronary arteries (28/49 vs 46/236; P 
ISSN:0022-5223
1097-685X
DOI:10.1016/j.jtcvs.2019.02.122