Anomalous aortic origin of the coronary arteries: a presentation of three cases and review of the literature

In this retrospective review of three patients presenting with anomalous aortic origin of the coronary arteries (AAOCA), we sought to highlight the varying presentations, discuss the optimal diagnostic imaging strategy and review current guidelines on the management of this condition. Over a one-year period three patients with AAOCA were identified. Pertinent data were extracted from case records and imaging, management and outcomes were reviewed in detail. All three patients had an anomalous right coronary artery originating from the left coronary sinus (AORCA) as well as a malignant course between the aorta and pulmonary artery. Although conventional angiography suggested the diagnosis, CT coronary angiography (CTA) was more useful in describing the anatomy and course of the anomalous artery and determining the necessity for and guidance to the type of surgical intervention required. All three patients underwent successful surgery. A brief literature review of the implications and management of this condition is provided.