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ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH ARTERIAL COMPRESSION - CASE REPORT
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  • Davi Tenório,
  • Leonardo Miana,
  • Antonio Carlos de Almeida Barbosa Filho,
  • Monica Gonzales Coronel,
  • Gustavo Guerreiro,
  • Valdano Manuel,
  • Marcelo Jatene,
  • fabio Jatene
Davi Tenório
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Leonardo Miana
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Antonio Carlos de Almeida Barbosa Filho
Centro Universitário CESMAC
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Monica Gonzales Coronel
Universidade de São Paulo Instituto do Coração
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Gustavo Guerreiro
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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Valdano Manuel
Clínica Girassol
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Marcelo Jatene
Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo
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fabio Jatene
Instituto do Coração, Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo
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Abstract

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.

Peer review status:ACCEPTED

18 Dec 2020Submitted to Journal of Cardiac Surgery
21 Dec 2020Submission Checks Completed
21 Dec 2020Assigned to Editor
29 Dec 2020Reviewer(s) Assigned
28 Jan 2021Review(s) Completed, Editorial Evaluation Pending
28 Jan 2021Editorial Decision: Revise Minor
16 Feb 20211st Revision Received
25 Feb 2021Submission Checks Completed
25 Feb 2021Assigned to Editor
24 Mar 2021Reviewer(s) Assigned
04 Apr 2021Review(s) Completed, Editorial Evaluation Pending
04 Apr 2021Editorial Decision: Accept