Aubry Pierre, Halna du Fretay Xavier, Boudvillain Olivier, Degrell Philippe
Bichat Hospital, Department of Cardiology, Paris, France.
entre Hospitalier de Gonesse, Department of Cardiology, Gonesse, France.
Front Cardiovasc Med. 2021 Jan 18;7:596018. doi: 10.3389/fcvm.2020.596018. eCollection 2020.
Few patients with an anomalous aortic origin of a coronary artery (AAOCA) require a correction of this congenital anomaly. Current recommendations offer surgical repair as a first line therapy to prevent a sudden cardiac death as a main objective. However, these guidelines are focused on children and not based on randomized controlled studies. Furthermore, decision-making should be different in an adult population less exposed to the risk of sudden cardiac death. Current practices showed reluctance to offer a surgical treatment for right AAOCA associated with ischemic symptoms or myocardial ischemia. Our aim in this review is to expose the rationale for percutaneous coronary intervention in right AAOCA with interarterial course and to present the published results.
很少有冠状动脉异常起源(AAOCA)的患者需要矫正这种先天性异常。目前的建议将手术修复作为一线治疗方法,主要目标是预防心源性猝死。然而,这些指南主要针对儿童,并非基于随机对照研究。此外,在心脏性猝死风险较低的成年人群中,决策应该有所不同。目前的实践表明,对于伴有缺血症状或心肌缺血的右冠状动脉异常起源,不愿提供手术治疗。本综述的目的是阐述经皮冠状动脉介入治疗右冠状动脉异常起源并走行于动脉之间的理论依据,并展示已发表的结果。