The role of coronary artery reimplantation for anomalous right coronary artery originating from the opposite sinus of Valsalva: preliminary outcomes and insights from a Latin American country

TL;DR

This paper presents the outcomes of coronary artery reimplantation for a specific heart condition in patients from a Latin American country, showing it is effective and safe.

Contribution

The study provides preliminary evidence supporting reimplantation as a suitable surgical technique for ACAOS in resource-limited settings.

Findings

Reimplantation showed high symptom control and functional recovery with low complication rates.

The technique is effective even in middle-aged patients with high-risk features.

Noninvasive anatomical assessments and symptoms are advocated over ischaemia tests for decision-making.

Abstract

Despite promising results, reimplantation appears to have fallen into oblivion among the multiple possible approaches for repairing anomalous coronary arteries. We describe the outcomes of 12 patients with an anomalous right coronary artery originating from the opposite sinus of Valsalva with an interarterial course who were surgically treated with this technique between 2018 and 2023 in 2 institutions in Bogota, Colombia. We provide preliminary evidence of the value reimplantation as a more than suitable technique, particularly in resource-constrained settings. It offers high rates of control of symptoms and functional class recovery while assessing all potential high-risk features, with a low risk of complications, even in middle-aged patients. We also advocate using noninvasive anatomical descriptions and patient symptoms over inducible ischaemia tests in decision making.

The recent increase in diagnosed cases of anomalous coronary arteries originating from the opposite sinus of Valsalva (ACAOS) is of great interest [1, 2].

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