{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T19:39:28Z","timestamp":1781206768008,"version":"3.54.1"},"reference-count":24,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["World J Pediatr Congenit Heart Surg"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Anomalous aortic origin of a coronary artery (AAOCA) is a significant cause of sudden cardiac death (SCD) in children and adolescents. The natural history of AAOCA and the pathophysiology of AAOCA-related SCD are poorly understood. Therefore, the evaluation and management of AAOCA remain controversial. This survey-based study aims to report the current AAOCA management tendencies in Canada.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We built a 23-question survey on AAOCA. Questions pertained to patient presentation, investigations, morphology of the anomaly, management, and follow-up. We sent the survey to all the Canadian congenital cardiac surgeons, pediatric cardiologists, and adult congenital cardiologists. Data were anonymized and analysis was performed using descriptive statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>According to our survey participants (N = 47), patient age (94%) and amount of physical activity (60%) are the most influential factors when deciding whether to offer surgical correction. Aborted SCD, exercise-induced syncope, typical chest pain, and left jaw or arm pain are the most important clinical presentations indicating surgery. The most commonly used preoperative investigations are rest echocardiography (75%), electrocardiogram (68%), and exercise stress test (62%). Most respondents favor the unroofing procedure (78%) for surgical correction. For nonsurgical candidates, most physicians choose competitive exercise restriction (64%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>We found a divergence between current practices and expert consensus guidelines regarding the treatment of asymptomatic left AAOCA with high-risk features. Our survey also revealed a lack of consensus among clinicians regarding the management of asymptomatic patients, very young patients, and those with right-sided AAOCA. Evidence-based criteria derived from sufficiently powered studies remain to be established to standardize AAOCA treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2150135121999030","type":"journal-article","created":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T06:12:19Z","timestamp":1620108739000},"page":"387-393","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":15,"title":["Current Management of Anomalous Aortic Origin of a Coronary Artery: A Pan-Canadian Survey"],"prefix":"10.1177","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3578-1305","authenticated-orcid":false,"given":"Kenza","family":"Rahmouni","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, University of Ottawa Heart Institute, University of Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre-Luc","family":"Bernier","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, McGill University, Montreal, Canada"},{"name":"Division of Cardiac Surgery, Montreal Children\u2019s Hospital, McGill University Health Center, Montreal, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"key":"bibr1-2150135121999030","doi-asserted-by":"publisher","DOI":"10.4103\/0974-2069.74035"},{"key":"bibr2-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-009-9461-y"},{"key":"bibr3-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1177\/2150135113516984"},{"key":"bibr4-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12511"},{"key":"bibr5-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1007\/s10554-010-9617-0"},{"key":"bibr6-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCIMAGING.113.000278"},{"key":"bibr7-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.01.031"},{"key":"bibr8-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1053\/j.pcsu.2015.12.007"},{"key":"bibr9-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2016.06.066"},{"key":"bibr10-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jelectrocard.2015.01.010"},{"key":"bibr11-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1111\/chd.12501"},{"key":"bibr12-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000696"},{"key":"bibr13-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000240"},{"key":"bibr14-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.119.008375"},{"key":"bibr15-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1177\/2150135116668333"},{"key":"bibr16-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.08.116"},{"key":"bibr17-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2007.02.051"},{"key":"bibr18-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2017.11.003"},{"key":"bibr19-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt614"},{"key":"bibr20-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2006.10.011"},{"key":"bibr21-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1093\/mmcts\/mmt022"},{"key":"bibr22-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1007\/s12471-012-0324-4"},{"key":"bibr23-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.055"},{"key":"bibr24-2150135121999030","doi-asserted-by":"publisher","DOI":"10.1017\/S1047951115002061"}],"container-title":["World 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