Akademik Veri Yönetim Sistemi
Turkish Journal of Thoracic and Cardiovascular Surgery, cilt.34, sa.1, ss.46-55, 2026 (SCI-Expanded, Scopus)
Background: Anomalous aortic origin of coronary arteries (AAOCA) is the second leading cause of sudden cardiac death in young athletes and poses significant diagnostic and management challenges due to its variable anatomy and unpredictable clinical course. Methods: We retrospectively analyzed 17 pediatric patients (10 male, 7 female; median age 12 years) diagnosed with AAOCA between 2016 and 2025. All patients underwent echocardiography and electrocardiogram-gated computed tomography angiography. Risk stratification considered interarterial course, intramural segment, and ostial morphology. Results: Anomalous right coronary artery was most common (n=11, 64.7%), followed by anomalous left coronary artery (ALCA) (n=4, 23.5%) and anomalous circumflex arteries (n=3, 17.6%). Interarterial course was present in 12 patients (70.6%), and intramural course in 9 patients (52.9%). The main presenting symptoms were exercise-induced chest pain (n=10, 58.8%), syncope (n=8, 47.1%), dizziness (n=7, 41.2%), and palpitations (n=6, 35.3%). Syncope was predominantly observed in ALCA patients with interarterial course. Among 15 patients aged ≥8 years who underwent exercise stress testing, 6 (40%) showed inducible ischemia. Nine patients (52.9%) underwent surgical intervention, including unroofing (n=7), ostial reimplantation (n=1), and pulmonary artery translocation (n=1). The remaining eight patients (47.1%) were managed conservatively, six of whom received beta-blocker therapy. Conclusion: Transthoracic echocardiography reliably identified AAOCA, showing excellent concordance with computed tomography and surgical findings. Standardized echocardiographic protocols are crucial, especially for children presenting with unexplained syncope or exertional symptoms, and can guide optimal management strategies.