Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience
Abstract Purpose An anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital heart disease. Some high-risk anatomical structures are at risk of inducing cardiogenic shock or even sudden death. This article summarizes our surgical experience with AAOCA in paediatric patients. Metho...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2025-01-01
|
| Series: | BMC Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12893-025-02781-4 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832586088214953984 |
|---|---|
| author | Kai Luo Bin Ji Qi-Liang Zhang Xiao-Yang Zhang Yan-Jun Pan Zhong-Qun Zhu Qiang Chen Xiao-Min He Jing-Hao Zheng |
| author_facet | Kai Luo Bin Ji Qi-Liang Zhang Xiao-Yang Zhang Yan-Jun Pan Zhong-Qun Zhu Qiang Chen Xiao-Min He Jing-Hao Zheng |
| author_sort | Kai Luo |
| collection | DOAJ |
| description | Abstract Purpose An anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital heart disease. Some high-risk anatomical structures are at risk of inducing cardiogenic shock or even sudden death. This article summarizes our surgical experience with AAOCA in paediatric patients. Methods We retrospectively analysed the clinical data of 27 paediatric AAOCA patients admitted to the Department of Cardiothoracic Surgery in our hospital from July 2015 to June 2023 and summarized the surgical treatment experience and follow-up results. Results A total of 27 patients were included in this study, including 14 patients with an anomalous left coronary artery (ALCA) and 13 patients with an anomalous right coronary artery (ARCA). A comparison of clinical data between ALCA and ARCA patients revealed that the preoperative left ventricular ejection fraction (LVEF) in ALCA patients was significantly lower than that in ARCA patients (p < 0.05). There were significantly more patients with preoperative complications, such as major adverse cardiovascular events (MACEs) and mitral regurgitation (MR), in the ALCA group than in the ARCA group (p < 0.05). No postoperative adverse events such as severe bleeding, mediastinitis, central nervous system complications, the need for reoperation, pacemaker implantation, pleural effusion complications occurred after operation.The duration of follow-up was 58.5 (31.5, 77.3) months. During the follow-up period, none of the patients presented symptoms such as chest tightness or chest pain, and cardiac CTA revealed unobstructed coronary arteries. Compared with the preoperative LVEF, the LVEF significantly improved at the last follow-up (p < 0.05). Conclusions Patients with an AAOCA should be taken seriously, and surgical treatment should be considered for these patients. Surgery should be considered for patients with ALCA as well as patients with ARCA with symptoms of myocardial ischaemia or a positive diagnosis of myocardial ischaemia or ventricular arrhythmia. For patients with other congenital heart defects that require surgical treatment, if the AAOCA is a high-risk anatomical structure, simultaneous surgery should be considered. The surgical method should be tailored to the coronary artery anatomy of the individual patient. |
| format | Article |
| id | doaj-art-ccacec77418647c48b5ab4b779ec0dd8 |
| institution | Kabale University |
| issn | 1471-2482 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj-art-ccacec77418647c48b5ab4b779ec0dd82025-01-26T12:12:44ZengBMCBMC Surgery1471-24822025-01-012511810.1186/s12893-025-02781-4Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experienceKai Luo0Bin Ji1Qi-Liang Zhang2Xiao-Yang Zhang3Yan-Jun Pan4Zhong-Qun Zhu5Qiang Chen6Xiao-Min He7Jing-Hao Zheng8Department of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Anesthesiology, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Cardiac Surgery, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), Fujian Medical UniversityDepartment of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Cardiac Surgery, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Children’s Hospital (Fujian Branch of Shanghai Children’s Medical Center), Fujian Medical UniversityDepartment of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityDepartment of Cardiothoracic Surgery, Heart Center, School of Medicine, Shanghai Children’s Medical Center, Shanghai Jiaotong UniversityAbstract Purpose An anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital heart disease. Some high-risk anatomical structures are at risk of inducing cardiogenic shock or even sudden death. This article summarizes our surgical experience with AAOCA in paediatric patients. Methods We retrospectively analysed the clinical data of 27 paediatric AAOCA patients admitted to the Department of Cardiothoracic Surgery in our hospital from July 2015 to June 2023 and summarized the surgical treatment experience and follow-up results. Results A total of 27 patients were included in this study, including 14 patients with an anomalous left coronary artery (ALCA) and 13 patients with an anomalous right coronary artery (ARCA). A comparison of clinical data between ALCA and ARCA patients revealed that the preoperative left ventricular ejection fraction (LVEF) in ALCA patients was significantly lower than that in ARCA patients (p < 0.05). There were significantly more patients with preoperative complications, such as major adverse cardiovascular events (MACEs) and mitral regurgitation (MR), in the ALCA group than in the ARCA group (p < 0.05). No postoperative adverse events such as severe bleeding, mediastinitis, central nervous system complications, the need for reoperation, pacemaker implantation, pleural effusion complications occurred after operation.The duration of follow-up was 58.5 (31.5, 77.3) months. During the follow-up period, none of the patients presented symptoms such as chest tightness or chest pain, and cardiac CTA revealed unobstructed coronary arteries. Compared with the preoperative LVEF, the LVEF significantly improved at the last follow-up (p < 0.05). Conclusions Patients with an AAOCA should be taken seriously, and surgical treatment should be considered for these patients. Surgery should be considered for patients with ALCA as well as patients with ARCA with symptoms of myocardial ischaemia or a positive diagnosis of myocardial ischaemia or ventricular arrhythmia. For patients with other congenital heart defects that require surgical treatment, if the AAOCA is a high-risk anatomical structure, simultaneous surgery should be considered. The surgical method should be tailored to the coronary artery anatomy of the individual patient.https://doi.org/10.1186/s12893-025-02781-4Anomalous aortic origin of the coronary arteryMajor adverse cardiovascular eventsSurgeryPaediatric |
| spellingShingle | Kai Luo Bin Ji Qi-Liang Zhang Xiao-Yang Zhang Yan-Jun Pan Zhong-Qun Zhu Qiang Chen Xiao-Min He Jing-Hao Zheng Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience BMC Surgery Anomalous aortic origin of the coronary artery Major adverse cardiovascular events Surgery Paediatric |
| title | Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience |
| title_full | Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience |
| title_fullStr | Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience |
| title_full_unstemmed | Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience |
| title_short | Surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients: a Chinese single-center experience |
| title_sort | surgical treatment of anomalous aortic origin of the coronary artery in paediatric patients a chinese single center experience |
| topic | Anomalous aortic origin of the coronary artery Major adverse cardiovascular events Surgery Paediatric |
| url | https://doi.org/10.1186/s12893-025-02781-4 |
| work_keys_str_mv | AT kailuo surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT binji surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT qiliangzhang surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT xiaoyangzhang surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT yanjunpan surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT zhongqunzhu surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT qiangchen surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT xiaominhe surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience AT jinghaozheng surgicaltreatmentofanomalousaorticoriginofthecoronaryarteryinpaediatricpatientsachinesesinglecenterexperience |