Anomalous Origin of Coronary Arteries

Veras FHAP, et al. Anomalous Origin of Coronary Arteries. Rev Bras Cardiol Invas 2007; 15(3).techniques varied between 75 and 80% in the 80s 37 .Nowadays, mortality is situated between 0 and 23% 37 .The clinical evolution and functional recovery ofthe left ventricle will depend upon the dysfunctionalventricular degree before the surgery. In most cases,there is a normalization of the ventricular function afterthe operation 11,13,37-40 .Bearers of OACEA, in general, are asymptomatic 12 .Even in athletes, only a minority is symptomatic 12 . And,in symptomatic individuals, the ECG and ischemia inducingexams, are generally normal 8,12,28 . The presenceof symptoms suggestive of the illness, especially inathletes, must be investigated through imaging exams.In the case in which echocardiograms are unable todiagnose the anomalous origin, TCAC, RNM or CA ofthe coronary arteries must be performed 8,28 .There is no consensus in the literature for the managementof asymptomatic bearers of OACEA. In symptomaticpatients, the surgical option must be chosen 12,28 .Figura 3 - Atresia do TCE em um paciente portador de valva aórtica bicúspide e ducto arterioso patente. A: cineangiocoronariografia mostrandoque a artéria circunflexa(Cx) origina-se da artéria coronária direita(CD). A artéria descendente anterior(DA) enche-se retrogradamente e formauma fístula com a artéria pulmonar(AP). B: no corte axial da RNM, observa-se uma falsa inserção da DA na AP. C: imagem axial da Cxoriginando-se da CD. Ao: aorta; AD: átrio direito; VE: ventrículo esquerdo(adaptado de Taylor et al. 17 )6