What is an Anomalous Coronary Artery Intervention & How is it Done?

Coronary artery is the artery that supplies blood to the cardiac muscles. Coronary artery anomaly (CAA) is a defect in one or more of coronary arteries. Another name for CAA is anomalous coronary artery (ACA). The defect is congenital. Anomalous coronary artery can be used to describe any defects in the coronary artery, such as an abnormal size or shape.

The heart pumps blood to the body and lungs. But it also needs its own supply of blood to keep it alive. This is the job done by coronary arteries. Coronary arteries divided in two main branches; right and left. These arteries arise from the sinuses. The right coronary artery arise from the right aortic sinus and the left one arises from the left coronary sinus. These two further branch off into other coronary arteries. This branching, in some people, is abnormal and this is since birth. So this condition is congenital and no specific reasons are known which cause it to occur. In many cases there are no symptoms at all till the child reaches its teen and sometimes it may not have any symptoms at all throughout the subject’s life. However, in some cases, severe complications as well as sudden death may occur.

The most common coronary anomaly is an anomalous origin of the left circumflex artery, either as branch of the right coronary artery or separately from the right coronary sinus. Anomalous origin of the right coronary artery from the left coronary sinus is the second most common coronary anomaly. There are many other types as well.

Talking to your healthcare provider about how to prepare for your anomalous coronary artery intervention procedure will help you ease out the possible anxiety that you may have about the procedure. Tell your healthcare provider about all the medicines you take. This includes over-the-counter medicines such as aspirin. You may need to stop taking some medicines ahead of time, such as blood thinners. If you smoke, you’ll need to stop before your anomalous coronary artery intervention procedure.

Some tests might be done before undergoing the anomalous coronary artery intervention procedure, like:

• ECG to check the heart rhythm
• Chest X-ray
• Blood tests
• Multidetector CT scan if more information on blood vessels is needed

You will be expected to not consume any solid or liquid after midnight the night before the surgery. You must tell your healthcare provider about any changes in your health, such as fever etc.

1. An IV line will be put before the anomalous coronary artery intervention procedure. You will get sedatives through this line to relax you during the procedure.
2. The area of the anomalous coronary artery intervention procedure may be numbed with a local anesthetic.
3. The healthcare provider will make a small incision in a blood vessel in your groin or wrist. He or she will then insert a long, thin wire into this cut. The wire acts as a guide for during the procedure.
4. The healthcare provider will then insert a thin, flexible tube (catheter) over the wire. It has a tiny deflated balloon on the end. The catheter will be threaded through the blood vessel all the way into the coronary artery. Continuous X-ray images may be used to show exactly where the catheter is.
5. The balloon will be inflated inside the narrow part of the artery. This will stretch the area open.
6. A mesh tube called a stent may be left in place in the area. This will help keep the area open.
7. The balloon will be deflated, and the catheter will be removed.
8. The incision site in the groin or wrist will be closed and bandaged.

The patient spends several hours in the recovery room following anomalous coronary artery intervention procedure. Your vital signs will be observed such as heart rate and breathing. You will be given pain medicines if needed. Your hospital stay will depend on your condition post surgery. Mostly, you just need to stay overnight. Your healthcare provider will tell you more about what to expect. After being discharged, you may have to take medicines to help prevent blood clots. You may also need to take antibiotics. Pain medicines can be used as guided by your healthcare provider.

You can get back to your normal activities following anomalous coronary artery intervention procedure except for heavy lifting or strenuous activities. You must keep up with your follow up appointments for your healthcare provider to track your progress. Your doctor may order follow-up tests which may include an electrocardiogram.

Call your healthcare provider in case of:

• Chest pain
• Fever
• Any leakage from the incision site
• Pain or swelling getting worse

Follow advice of your healthcare provider about medicines, exercise, and incision care.

The risks of anomalous coronary artery intervention procedure include:

• Heart attack
• Infection
• Excess bleeding
• Allergic reaction to the dye
• Need for coronary artery bypass grafting, if the artery doesn’t open with the procedure
• Blood vessel damage from the catheter
• Risks are always based on your overall health and severity of your condition.

Before you agree to undergo a anomalous coronary artery intervention procedure, make sure you understand all the crucial aspects of the surgery like risks vs. benefits, how is the anomalous coronary artery intervention procedure done, what you can expect after the surgery etc. so that you are not anxious before the procedure. Make sure your surgeon holds good amount of experience on the surgery. You may also consider taking a second opinion if you are not convinced or are not sure about going through the procedure. Once you have decided to go for the surgery, you must completely trust your healthcare provider and follow all the instructions given by him. It will help you ease out during the anomalous coronary artery intervention procedure and will add on to your smoother recovery.