Department of Cardiology, CAHAL, Center for Congenital Heart Disease Amsterdam Leiden, Leiden University Medical Center, Leiden, Netherlands.
Department of Anatomy and Embryology, Leiden University Medical Center, Leiden, Netherlands.
Interact Cardiovasc Thorac Surg. 2021 Jan 1;32(1):122-129. doi: 10.1093/icvts/ivaa234.
The aim of this study is to describe the significance of symptoms preoperatively and at medium-term follow-up in adolescent and adult patients who underwent surgery of anomalous aortic origin of a coronary artery (AAOCA).
Consecutive patients who underwent surgery for AAOCA in our tertiary referral centre between 2001 and 2018 were included. Clinical characteristics and symptoms were evaluated and medium-term outcomes were recorded. Symptoms were classified according to the '2019 ESC guidelines on chronic coronary syndromes'.
A total of 53 (55% male) patients with mean age of 44 at time of surgery underwent surgical repair of AAOCA. Data on symptoms and events ˃3 months after surgery were available in 34 patients with a median follow-up of 3 years (interquartile range 1.0-5.3). Preoperatively, only 35% patients had typical anginal complaints. After surgical correction of AAOCA, 59% of the patients were free of symptoms, compared to 6% preoperatively (P < 0.001). A total of 3 (9%) patients needed a reoperation/reintervention related to the operated AAOCA. All 3 patients presented postoperatively with novel typical anginal complaints.
Adolescent and adult patients with AAOCA present with varying symptoms. Only 35% have typical anginal complaints. Surgical correction of AAOCA reduces the symptoms in the vast majority of patients. One should be aware of potential lesions of the operated coronary artery in patients presenting with typical anginal complaints postoperatively.
本研究旨在描述接受冠状动脉异常起源于主动脉手术（AAOCA）的青少年和成年患者术前和中期随访时症状的意义。
纳入 2001 年至 2018 年期间在我们的三级转诊中心接受 AAOCA 手术的连续患者。评估临床特征和症状，并记录中期结果。根据“2019 ESC 慢性冠状动脉综合征指南”对症状进行分类。
共有 53 名（55%为男性）患者在手术时的平均年龄为 44 岁，接受了 AAOCA 的手术修复。在手术治疗后 ˃3 个月，有 34 名患者有症状和事件数据，中位随访时间为 3 年（四分位距 1.0-5.3）。术前，仅有 35%的患者有典型心绞痛症状。手术后，59%的患者无症状，而术前为 6%（P<0.001）。共有 3（9%）名患者需要再次手术/介入治疗与手术治疗的 AAOCA 相关。所有 3 名患者术后均出现新的典型心绞痛症状。
患有 AAOCA 的青少年和成年患者表现出不同的症状。只有 35%的患者有典型心绞痛症状。AAOCA 的手术矫正可使绝大多数患者的症状减轻。对于术后出现典型心绞痛症状的患者，应注意可能存在的已手术治疗的冠状动脉病变。
