Anomalous aortic origin of the coronary arteries in a 12-year-old male: a case report
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CASE REPORT
Anomalous aortic origin of the coronary arteries in a 12‑year‑old male: a case report Jing Zheng1, Yuru Lan2, Qiang Fan2, Yunfei Ling2 and Yongjun Qian2*
Abstract Background: Anomalous aortic origin of the coronary artery (AAOCA) is a rare congenital cardiac disease that can cause sudden cardiac death. This condition may be corrected with surgery. Among the different surgical techniques used to correct this malformation, the most common are unroofing and lateral pulmonary translocation. Case presentation: Herein, we present a multimodal imaging approach to identifying AAOCA in a 12-year-old male. We also successfully adopted a new operative method, neo-ostium creation combined with lateral pulmonary translocation to correct AAOCA. The detailed imaging and intraoperative data has not been reported in the literature. Conclusions: Although several surgical methods exist to reverse the complications of AAOCA, we offer an innovative surgical technique that is easier, faster, and effective. Keywords: Anomalous aortic origin of a coronary artery, Neo-ostium creation, Lateral pulmonary translocation, Case report Background Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart condition wherein a coronary artery originates from the wrong aortic sinus and follows an interarterial, intramural, or intraconal course [1]. While AAOCA is rare, it is the second leading cause of death in young athletes, The incidence rate is about 0.01%–0.2 [2]. All types of AAOCA are associated with the risk of coronary flow obstruction and myocardial ischemia, which may lead to sudden cardiac death [1]. Studies have shown that the right coronary artery is more involved in the incidence of AAOCA than the left coronary artery [3]. However, AAOCA involving the left coronary artery carries a higher risk [4]. The current treatment guidelines for AAOCA recommend activity restriction and, in case of an increased *Correspondence: [email protected] 2 Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Guoxuexiang 37th, Chengdu 610041, Sichuan, People’s Republic of China Full list of author information is available at the end of the article
risk, surgical intervention [5]. In the presence of an intramural segment, the unroofing surgery is performed [6]. However, to our knowledge, a surgery that combines both neo-ostium creation and lateral pulmonary translocation in patients with AAOCA has not been reported. This report describes a rare case of a 12-year-old male with AAOCA who successfully underwent this innovative combined surgery (neo-ostium creation and lateral pulmonary translocation). Additionally, it details imaging and intraoperative information to provide an alternative approach to treating AAOCA.
Case presentation A 12-year-old male was admitted to the hospital following sudden syncope after strenuous activity. The echocardiography showed the color in the left coronary artery. ECG revealed that the sinus rhythm was missing the ST segment and alterations in
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