Evaluation of Myocardial Ischemia After Surgical Repair of Anomalous Aortic Origin of a Coronary Artery in a Series of Pediatric Patients

Evaluation of Myocardial Ischemia After Surgical Repair of Anomalous Aortic Origin of a Coronary Artery in a Series of Pediatric Patients Julie A. Brothers, Michael G. McBride, Mohamed A. Seliem, Bradley S. Marino, Ryan S. Tomlinson, Miguel H. Pampaloni, J. William Gaynor, Thomas L. Spray, Stephen M. Paridon Anomalous aortic origin of a coronary artery that courses between the great vessels is a rare anomaly associated with increased myocardial ischemia and sudden death risk in children. We prospectively assessed children with exercise stress test, stress echocardiogram, and stress myocardial perfusion scan. One anomalous origin of left main coronary artery patient and 8 anomalous right coronary (ARCA) patients had positive ischemia evaluations. Subclinical changes suggestive of ischemia might occur despite patent neo-coronary ostia, notably after ARCA repair.