Dice Question Streamline Icon: https://streamlinehq.com

Identify which AAOCA patients benefit from surgery versus can safely exercise

Determine the clinical criteria or predictive markers that identify which patients with anomalous aortic origin of a coronary artery, particularly those with right-sided AAOCA, should undergo surgical intervention versus those who can safely continue exercise, given that abnormal morphologic features do not reliably distinguish patients with and without myocardial ischemia.

Information Square Streamline Icon: https://streamlinehq.com

Background

Risk stratification in anomalous aortic origin of a coronary artery (AAOCA) is challenging because similar morphologic features appear in patients both with and without myocardial ischemia. This uncertainty complicates clinical decision-making regarding whether to recommend surgery or allow continued exercise, especially in right-sided AAOCA, which is more prevalent.

The paper motivates the need for non-invasive predictive tools but explicitly acknowledges that determining who benefits from surgery versus who is safe to exercise remains unresolved.

References

Thus, it is unclear which patients may benefit from surgical intervention and which are safe to continue to exercise, especially in the setting of right (R-)AAOCA, a subtype 4-6 times more prevalent than left (L-)AAOCA.

— Fluid-structure interaction simulations for the prediction of fractional flow reserve in pediatric patients with anomalous aortic origin of a coronary artery (2405.01703 - Puelz et al., 2 May 2024) in Introduction (Section 1)