Multicenter Study on Coronary Anomalies in The Netherlands

Evidence for the treatment of patients with coronary anomalies is scarce and treatment decisions are thus very heterogeneous, especially for patients with an anomalous coronary artery from the opposite sinus (ACAOS) with an interarterial course, that are potentially prone to sudden cardiac death. In this study, prospectively included patients with an ACAOS receive work-up according to a structured protocol using CT-angiography, ischemia detection testing, echocardiography and coronary angiography with intracoronary measurements to assess anatomical and physiological characteristics of the ACAOS. During follow-up, surgical and functional results are evaluated by CT-angiography, ischemia detection testing and a quality-of-life-questionnaire. Evaluated are (cardiac) death, myocardial ischemia attributable to the ACAOS, re-intervention after surgery and intervention after initially conservative treatment, and the influence of work-up examinations on treatment choice. Patients are followed-up for at least 2 years.
Registry is done for patients with right or left coronary artery from the pulmonary artery and coronary arteriovenous fistulas.
The aim is to provide evidence substantiated recommendations for diagnostic work-up, treatment and follow-up of patients with anomalous coronary arteries.

N.A.

September 2020 start enrollment
December 2023 end enrollment
2026 end of follow-up last included patient

-Coronary CT angiography, using 0.5-1mm slices (work-up and follow-up after surgery)
-Transthoracic echocardiography (work-up)
-CAG with IVUS and FFR measurement (and iFR or CFR) of the interarterial and septal ACAOS using adrenalin and adenosine or dobutamin (work-up)
-Ischemia detection test (work-up and follow-up after surgery)
Every participating hospital will perform the tests according to the physicians insights and possibilities of the hospital. Preferably all examinations are done as standard of care, because each test examines a different fysiological aspect.