Outcomes of a protocolized approach for surgical unroofing of intramural anomalous aortic origin of coronary artery in children and adults.

Objective: Management of anomalous aortic origin of coronary arteries has been variable, and limited data are available on early and late outcomes.

Methods: We report a single institution's experience with a protocolized approach to 148 consecutive patients who underwent surgical unroofing of intramural anomalous aortic origin of coronary arteries (June 2003 to December 2020). The management algorithm included preoperative and postoperative cross-sectional and echocardiographic imaging, exercise testing, and a standardized operative technique.

ACR Appropriateness Criteria Acute Chest Pain-Suspected Pulmonary Embolism.

Pulmonary embolism (PE) remains a common and important clinical condition that cannot be accurately diagnosed on the basis of signs, symptoms, and history alone. The diagnosis of PE has been facilitated by technical advancements and multidetector CT pulmonary angiography, which is the major diagnostic modality currently used. Ventilation and perfusion scans remain largely accurate and useful in certain settings.

ACR Appropriateness Criteria Dyspnea-Suspected Cardiac Origin.

This article discusses imaging guidelines for five dyspnea variants: (1) dyspnea due to heart failure, ischemia not excluded; (2) dyspnea due to suspected nonischemic heart failure, ischemia excluded; (3) dyspnea due to suspected valvular heart disease, ischemia excluded; (4) dyspnea due to suspected cardiac arrhythmia, ischemia excluded; and (5) dyspnea due to suspected pericardial disease, ischemia excluded. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios.

Survival and outcomes of patients with unoperated single ventricle.

Objective: Patients with unoperated single ventricle (SV) rarely survive into adulthood with good functional status and may develop Eisenmenger's syndrome (ES). We report outcomes of a 30-year cohort of such patients.

Methods: Adult patients with unoperated SV were identified by searching the Mayo Clinic medical record from 1984 to 2014.