The Diagnosis and Therapeutic Management of Anomalous Aortic Origin of the Coronary Artery: A Retrospective Study Conducted at a Single Center in China.

Abstract

Background: This study collected data on the incidence and management of anomalous aortic origin of the coronary artery (AAOCA). We described the incidence of AAOCA and the observed outcomes after management.

Methods: This retrospective study focused on patients treated for AAOCA in a tertiary hospital during the last 20 years. Patients were divided into the anomalous left coronary artery from the pulmonary artery (ALCAPA) group, the non-ALCAPA group, and the symptomatic and asymptomatic groups. Clinical manifestations and related data after surgery were compared among the different groups.

Results: From April 2003 to July 2022, 102 patients were diagnosed with AAOCA and treated at Beijing Anzhen Hospital. ALCAPA was identified as the most prevalent anomaly. The incidence of syncope and heart failure was significantly lower and higher, respectively, in the ALCAPA group. Surgical intervention yielded immediate benefits not only for ALCAPA patients but also for patients who underwent AAOCA. In total, 64.7% of the patients underwent coronary artery osteoplasty, which provided a comprehensive surgical approach addressing all anatomical issues associated with AAOCA. Compared to preoperative measurements, there was a significant reduction in the left ventricular end-diastolic diameter (LVEDD) after surgical intervention (p < 0.001). Both the ejection fraction (EF) before and after surgery and the incidence of inter-arterial abnormal vessels in the asymptomatic group were significantly higher than those observed in the symptomatic group (p < 0.001).

Conclusions: ALCAPA is most frequently observed among patients with AAOCA. Thus, surgical intervention benefits AAOCA patients, particularly asymptomatic individuals.