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Anomalous Aortic Origin of a Coronary Artery in Pediatric Patients.

Curr Pediatr Rep

May 2024

Coronary Artery Anomalies Program, Division of Cardiology, Texas Children's Hospital, 6651 Main Street MC-E1920, Houston, TX 77030 USA.

Purpose Of Review: We present a contemporary approach to risk assessment and management of patients with anomalous aortic origin of a coronary artery (AAOCA).

Recent Findings: Anomalous left coronary artery from the right aortic sinus (L-AAOCA) with interarterial course carries a high risk of sudden cardiac death (SCD); therefore, current guidelines recommend exercise restriction and surgical intervention. Recent data in intraseptal and juxtacommissural L-AAOCA showed inducible perfusion abnormalities, leading to consideration of surgical intervention.

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Background: Prenatal development of autonomic innervation of sinus venosus-related structures might be related to atrial arrhythmias later in life. Most of the pioneering studies providing embryological background are conducted in animal models. To date, a detailed comparison with the human cardiac autonomic nervous system (cANS) is lacking.

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Aims: To evaluate the association between transcatheter edge-to-edge repair (TEER) and outcomes in patients with significant mitral regurgitation (MR) following acute myocardial infarction (MI), focusing on the aetiology of acute post-MI MR in high-risk surgical patients.

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Myocardial bridging is a common coronary anomaly. Although it is considered to be a benign condition, it can rarely be complicated by myocardial infarction. Clinicians should be suspicious of myocardial bridging as an etiology of myocardial infarction when other more common etiologies have been excluded.

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