@Article{chd.12511,
AUTHOR = {Hitesh Agrawal, Carlos M. Mery, Patrick E. Day, S. Kristen Sexson Tejtel, E. Dean McKenzie, Charles D. Fraser Jr, Athar M. Qureshi, Silvana Molossi},
TITLE = {Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey},
JOURNAL = {Structural and Congenital Heart Disease},
VOLUME = {12},
YEAR = {2017},
NUMBER = {5},
PAGES = {610--614},
URL = {http://www.techscience.com/schd/v12n5/39207},
ISSN = {3071-1738},
ABSTRACT = {<b>Background:</b> Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of
sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients
are lacking to date. There is insufficient knowledge on the best approach to these patients and
they are managed in a nonuniform manner.<br/>
<b>Methods:</b> An online survey of 15 questions regarding management of AAOCA was sent out to
198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated
scientific forum for discussion of AAOCA. Descriptive statistics were performed.<br/>
<b>Results:</b> A total of 91 providers (46%) completed the survey including pediatric cardiology subspecialists (40%), general pediatric cardiologists (24%), cardiovascular (CV) surgeons (22%), adult cardiologists
(10%), nurse practitioners (8%), cardiology fellows (3%) and CV anesthesiologist (1%). Forty-eight percent had been practicing for over 15 years and 28% were in their first 5 years of practice. Fifty-two
percent of the providers cared for adults and 93% cared for children/adolescents. Eighty-eight percent
were affiliated with an academic institution. All but one provider practiced in the USA, 62% practiced
in Texas. Half of participants (50%) were very comfortable managing AAOCA patients and 36% were
somewhat comfortable. Providers utilized various imaging tests to confirm the anatomy including
computed tomography angiography 88%, cardiac magnetic resonance imaging 70%, cardiac catheterization 60%, echocardiogram 12%, IVUS 2% and myocardial perfusion scan 1%. The majority felt
comfortable in counseling the families and felt that depending on the type of lesion these patients
should get surgical referral (85%) vs clinical follow up (67%) with exercise restriction (65%).<br/>
<b>Conclusion:</b> There is heterogeneity in the way AAOCA patients are currently evaluated and managed. A knowledge gap exists even with participants from academic institutions. Long-term data
with a defined approach to management of these patients may help to improve outcomes and prevent unnecessary exercise restriction or surgery.},
DOI = {10.1111/chd.12511}
}