A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report
Anomalous aortic origin of a coronary artery (AAOCA) is a congenital malformation of the coronary arteries that includes several subtypes. It is a leading cause of sudden cardiac death in young people, especially in competitive athletes. An accurate diagnosis and identification of high-risk patients...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-05-01
|
| Series: | Frontiers in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1167698/full |
| _version_ | 1797822573268959232 |
|---|---|
| author | Hairun Zuo Chengyi Xu Li Wang Chengwei Liu Li Liu Xi Su |
| author_facet | Hairun Zuo Chengyi Xu Li Wang Chengwei Liu Li Liu Xi Su |
| author_sort | Hairun Zuo |
| collection | DOAJ |
| description | Anomalous aortic origin of a coronary artery (AAOCA) is a congenital malformation of the coronary arteries that includes several subtypes. It is a leading cause of sudden cardiac death in young people, especially in competitive athletes. An accurate diagnosis and identification of high-risk patients with AAOCA for referral for surgical repair can help in the management of these patients. However, current diagnostic tools such as invasive angiography, echocardiography, and intravascular ultrasound have known limitations in visualizing coronary orifices and characterizing vessels. In this case report, we report on a 14-year-old adolescent who suffered from repeated incidents of syncope during exercise. Using the computed tomographic fractional flow reserve (CT-FFR) technique, we diagnosed AAOCA, which revealed that his left coronary artery (LCA) originated from the right sinus of Valsalva and ran between the aorta and the pulmonary artery with an intra-arterial wall course (∼20 mm in length), with an abnormal FFR of the LCA at rest. The patient was referred for undergoing unroofing surgery, and the results of repeat CT-FFR showed a significantly improved FFR of the LCA. The patient resumed his normal physical activities without the recurrence of syncope. In this report, we highlight the usefulness of CT-FFR as a non-invasive, feasible, and effective tool to guide whether a patient with AAOCA requires surgical revascularization and to evaluate the effectiveness of the procedure after surgery. |
| first_indexed | 2024-03-13T10:11:06Z |
| format | Article |
| id | doaj.art-f6bf977b7fba41ac9ade3feeeddfbdc6 |
| institution | Directory Open Access Journal |
| issn | 2297-055X |
| language | English |
| last_indexed | 2024-03-13T10:11:06Z |
| publishDate | 2023-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Cardiovascular Medicine |
| spelling | doaj.art-f6bf977b7fba41ac9ade3feeeddfbdc62023-05-22T04:35:54ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2023-05-011010.3389/fcvm.2023.11676981167698A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case reportHairun ZuoChengyi XuLi WangChengwei LiuLi LiuXi SuAnomalous aortic origin of a coronary artery (AAOCA) is a congenital malformation of the coronary arteries that includes several subtypes. It is a leading cause of sudden cardiac death in young people, especially in competitive athletes. An accurate diagnosis and identification of high-risk patients with AAOCA for referral for surgical repair can help in the management of these patients. However, current diagnostic tools such as invasive angiography, echocardiography, and intravascular ultrasound have known limitations in visualizing coronary orifices and characterizing vessels. In this case report, we report on a 14-year-old adolescent who suffered from repeated incidents of syncope during exercise. Using the computed tomographic fractional flow reserve (CT-FFR) technique, we diagnosed AAOCA, which revealed that his left coronary artery (LCA) originated from the right sinus of Valsalva and ran between the aorta and the pulmonary artery with an intra-arterial wall course (∼20 mm in length), with an abnormal FFR of the LCA at rest. The patient was referred for undergoing unroofing surgery, and the results of repeat CT-FFR showed a significantly improved FFR of the LCA. The patient resumed his normal physical activities without the recurrence of syncope. In this report, we highlight the usefulness of CT-FFR as a non-invasive, feasible, and effective tool to guide whether a patient with AAOCA requires surgical revascularization and to evaluate the effectiveness of the procedure after surgery.https://www.frontiersin.org/articles/10.3389/fcvm.2023.1167698/fullanomalous aortic origin of a coronary arterysudden cardiac deathcomputed tomography angiographyfractional flow reserveunroofing procedure |
| spellingShingle | Hairun Zuo Chengyi Xu Li Wang Chengwei Liu Li Liu Xi Su A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report Frontiers in Cardiovascular Medicine anomalous aortic origin of a coronary artery sudden cardiac death computed tomography angiography fractional flow reserve unroofing procedure |
| title | A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report |
| title_full | A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report |
| title_fullStr | A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report |
| title_full_unstemmed | A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report |
| title_short | A CT-FFR-guided unroofing procedure for repairing the anomalous origin of the left coronary artery—a case report |
| title_sort | ct ffr guided unroofing procedure for repairing the anomalous origin of the left coronary artery a case report |
| topic | anomalous aortic origin of a coronary artery sudden cardiac death computed tomography angiography fractional flow reserve unroofing procedure |
| url | https://www.frontiersin.org/articles/10.3389/fcvm.2023.1167698/full |
| work_keys_str_mv | AT hairunzuo actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT chengyixu actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT liwang actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT chengweiliu actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT liliu actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT xisu actffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT hairunzuo ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT chengyixu ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT liwang ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT chengweiliu ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT liliu ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport AT xisu ctffrguidedunroofingprocedureforrepairingtheanomalousoriginoftheleftcoronaryarteryacasereport |