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Many people live long and healthy lives with coronary artery anomalies, yet some are at a higher risk for sudden cardiac arrest. Determining risk of sudden cardiac arrest is difficult and demands extensive exploration. To ensure that your child is healthy and free of this risk, we provide in-depth, leading-edge diagnoses, ongoing care, and top surgical solutions.

How we diagnose

Often, people with coronary artery anomalies do not have symptoms, and therefore many are not diagnosed until their teenage years or young adulthood. Coronary artery anomalies are usually picked up while a patient receives a test for another concern, such as a heart murmur or an evaluation for a family history of heart problems. To clarify your child’s risk level, we perform comprehensive, cutting-edge testing, which includes:

• Echocardiography in our dedicated Pediatric Echocardiography Stress Laboratory.
• Magnetic resonance imaging (MRI), including specialized tests such as a stress cardiac MRI.
• Computed tomography (CT) scan.
• Exercise stress testing in our advanced Cardiopulmonary Exercise Lab or another provocative stress test that analyzes heart function while the heart is pumping.
• Cardiac catheterization, a minimally invasive procedure that is sometimes used to take a deeper look at your child’s coronary anomaly, especially if it is a myocardial bridge. Our Pediatric Cardiac Catheterization and Interventional Cardiology program uses the latest devices and innovations, including a specialized diagnostic catheter procedure called a fractional flow reserve, to tell us whether or not your child’s myocardial bridge requires further treatment.
• Genetic testing and counseling—we provide research-supported genetic testing, when needed, to determine if there is a genetic cause for your child’s coronary anomaly. This is a fairly rare offering for a program like ours.

Our treatment approach for coronary artery anomalies

We offer a large breadth of expertise in many areas of pediatric heart care, which is rounded out by our renowned heart surgery expertise at Â鶹¹û¶³´«Ã½ Children’s Health. With us, your child receives holistic care and emotional support, including social services—counseling, planning, and education—child life and creative arts to help minimize stress to improve how children and families cope, and other patient and family services, including help finding lodging and making travel plans for your family.

For every child and young adult with heart disease, our first step is to diagnose risk of cardiac arrest. Once we deeply understand a patient’s heart anomaly, we provide one of the following care options:

Monitoring and managing

If your child’s coronary artery anomaly is lower risk and without symptoms, we follow the anomaly over time and provide medications as needed. We also offer regular follow-up testing, such as echocardiography, exercise stress testing, and telehealth appointments when possible. Most important, we offer intensive counseling of the patient and family, ensuring that they will recognize red flags that may arise.

Heart surgery

If your child is at high risk for sudden cardiac arrest and requires a heart surgery for anomalous aortic origins of coronary artery (AAOCA), rest assured that you are in excellent hands. Our Betty Irene Moore Children’s Heart Center heart surgeons specialize in coronary arteries and are nationally recognized for their decades-long exceptional surgical skills, outcomes, and innovations.

• For AAOCA, our surgical team has pioneered the most up-to-date techniques to treat coronary anomalies. Generally, there are two surgeries to treat AAOCA: a direct coronary artery reimplantation or a coronary artery unroofing procedure. Reimplantation is more difficult to perform and is not readily offered as a primary solution at many centers, yet it often has excellent results, including a very high survival rate and a very low chance of your child needing a reoperation.
• Due to our advanced techniques and skills, we offer reimplantation to most of our heart patients. With congenital coronary artery anomalies, sometimes the coronary artery develops in the wrong place. Reimplantation moves the coronary artery into the right position, while unroofing divides the muscle around the artery to improve blood flow. After a reimplantation procedure, your child’s anatomy will be close to normal.
• Myocardial bridges are fairly common in the general population and typically do not require surgery. However, in rare cases, bridges may be associated with arrhythmias or a decrease in blood flow to the surrounding areas of the heart. When this happens, a surgery can be performed to remove part of the muscle overlying the coronary artery.

Heart surgeries usually take about four hours from start to finish. During and after surgery, your child is cared for by some of the nation’s best heart surgeons, specialized cardiac anesthesiologists, and nurses. Your child’s aftercare is provided in our state-of-the-art Cardiovascular Intensive Care and Acute Cardiac Care units.