From the Guidelines
The condition in a newborn referred to as an aberrant coronary artery is a congenital heart defect where one or more coronary arteries have an abnormal origin or course, which can range from being asymptomatic to causing serious complications like myocardial ischemia. This condition is also known as anomalous aortic origin of a coronary artery (AAOCA) and can be characterized by one of five course subtypes: interarterial, subpulmonic, prepulmonic, retroaortic, or retrocardiac 1. The prevalence of anomalous coronary arteries is estimated to be between 0.99% to 5.8% in coronary CTA series 1. Some of the key characteristics of this condition include:
- Abnormal origin or course of one or more coronary arteries
- Increased risk for myocardial ischemia and sudden cardiac death in young patients
- Can be asymptomatic or symptomatic, with symptoms ranging from mild to severe
- Requires accurate delineation of coronary anatomy, including ostial status, coronary branching pattern, and presence and length of an intramural segment 1
- Can be diagnosed using echocardiography, CT, or CMR, with CMR being utilized to confirm diagnosis and assess myocardial function, perfusion, and infarction 1 Early detection and proper management of this condition are crucial to prevent serious complications and improve outcomes in newborns with aberrant coronary arteries. In terms of management, treatment depends on the severity of the condition and may include observation, medical management with beta-blockers to reduce cardiac workload, or surgical correction in severe cases 1.
From the Research
Condition in Newborns
The condition in a newborn referred to as an aberrant coronary (coronary) artery is not directly addressed in the provided studies. However, the studies discuss aberrant right subclavian arteries, which are a type of vascular anomaly.
Aberrant Right Subclavian Artery
- An aberrant right subclavian artery (ARSA) is a rare anatomical variant where the right subclavian artery originates as the final branch of the aortic arch 2.
- The prevalence of ARSA is less than 1% in the normal population, but it is more common in individuals with Down syndrome, with an incidence between 19% and 36% 3.
- ARSA can be associated with other vascular anomalies, such as Kommerell's diverticulum, and can cause symptoms such as dysphagia and upper extremity ischemia 4, 2.
Diagnosis and Management
- Computed tomography (CT) angiography is a useful diagnostic tool for identifying ARSA and other vascular anomalies 5, 2.
- Magnetic resonance angiography (MRA) can also be used to diagnose ARSA and other vascular anomalies 6.
- Management of ARSA depends on the presence of symptoms and associated anomalies, and may include surgical or percutaneous interventions 4.
Association with Down Syndrome
- An aberrant right subclavian artery may be a new ultrasound marker for Down syndrome, with a preliminary study suggesting that it is present in 35.7% of fetuses with Down syndrome 3.
- Further studies are needed to assess the incidence of ARSA in normal fetuses and to confirm its association with Down syndrome 3.