Evangelista Martina, Ferrero Paolo, D'Aiello Angelo Fabio, Negura Diana, Micheletti Angelo, Bevilacqua Francesca, Pasqualin Giulia, Chessa Massimo
ACHD Unit-Pediatric and Adult Congenital Heart Centre, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
Vita Salute San Raffaele University, Milan, Italy.
Transl Pediatr. 2024 Jul 31;13(7):1242-1257. doi: 10.21037/tp-24-30. Epub 2024 Jul 29.
In the literature have been widely discussed different classification criteria for coronary artery anomalies (CAAs), some authors have tried to categorize them only as "major" or "hemodynamically significant" anomalies versus "minor" or "not hemodynamically significant" ones. However, the most recent literature has concluded that all possible coronary anatomy should be taken into consideration in a comprehensive classification of CAAs. The aim of the article is to review the most recent literature regarding CAAs to provide a comprehensive overview of this challenging topic.
We propose a narrative overview of the most impactful and recent literature, synthetizing and re-elaborating the most important articles concerning CAAs.
The important gap of knowledge on the specific characteristics of CAAs has led to a progressively increased interest of the current research in this field. Albeit their nature is still unclear, an increased awareness of their fatality is spreading among clinicians and the general population, mostly associated with their clinical relevance among young patients and athletes. On the other side, we do believe that clinical and hemodynamic repercussions are of crucial importance and should always be integrated to understand the true nature of this important pathology.
In the field of pediatric cardiology, CAAs are one of the most fascinating and studied subject. We propose a state-of-the art review to provide a comprehensive and systematic description and subsequently an approach to the epidemiological, pathophysiological, and clinical aspects of the most important CAAs in the pediatric population.
文献中已广泛讨论了冠状动脉异常（CAA）的不同分类标准，一些作者试图仅将其分为“主要”或“血流动力学显著”异常与“次要”或“血流动力学不显著”异常。然而，最新文献得出结论，在CAA的综合分类中应考虑所有可能的冠状动脉解剖结构。本文的目的是回顾有关CAA的最新文献，以全面概述这一具有挑战性的主题。
我们对最具影响力和最新的文献进行叙述性综述，综合并重新阐述有关CAA的最重要文章。
关于CAA具体特征的知识存在重要空白，导致当前该领域研究兴趣逐渐增加。尽管其本质仍不明确，但临床医生和普通人群对其致命性的认识正在提高，这主要与其在年轻患者和运动员中的临床相关性有关。另一方面，我们确实认为临床和血流动力学影响至关重要，应始终将其结合起来以了解这一重要病理的真正本质。
在儿科心脏病学领域，CAA是最引人入胜且研究最多的主题之一。我们提出一篇最新综述，以全面系统地描述并随后探讨儿科人群中最重要CAA的流行病学、病理生理学和临床方面。
