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Background <p>Coronary artery anomalies (CAAs) are rare and heterogeneous congenital abnormalities. However, some of them are associated with serious consequences, including myocardial ischemia, heart failure, and even death. This study aimed to characterize symptoms, course, treatment, and prognosis of different types of CAAs.</p> Methods <p>This single-centre retrospective cohort study included 38 consecutive paediatric patients hospitalised in the Department of Paediatric Cardiology due to a diagnosis of CAAs between 01.2012–03.2025. Patients were divided into two groups: anomalous origin of the coronary arteries (Origin anomalies) and coronary artery fistulae (CAF), respectively, 20 and 18 patients. The collected data included clinical symptoms, laboratory tests, electrocardiography, echocardiographic parameters, course of treatment and long-term follow-up.</p> Results <p>The mean age of the analysed group was 3.32 ± 5.35 years (range: 1 day − 16 years; IQR0-4.25). The study group included 42% males. During the follow-up, no patient died. There were significant differences between groups in the occurrence of dyspnoea (<i>p</i> &lt; 0.001), cyanosis (<i>p</i> = 0.048), echocardiographic parameters: mitral insufficiency (<i>p</i> = 0.001), left ventricle dilatation (<i>p</i> &lt; 0.001), left ventricular end diastolic diameter z-score (<i>p</i> = 0.023) and end systolic diameter z-score (<i>p</i> = 0.004) and lower ejection fraction (<i>p</i> = 0.001), which was more prevalent in the origin anomalies group than in the CAF group. Moreover, lower haemoglobin (<i>p</i> = 0.006) and haematocrit (<i>p</i> = 0.005) were observed in the origin anomalies group compared to the CAF group.</p> Conclusions <p>Our study showed that prompt diagnosis and treatment, including transcatheter or surgical intervention, were associated with clinical improvement and no mortality observed during the follow-up period in the study group. Symptoms like dyspnoea, cyanosis, syncope, no weight gain, feeding disorder and fatigue, especially in younger children, should prompt us to expand the diagnosis and look for diseases such as CAAs. Additionally, patients with origin anomalies had more frequent cyanosis, dyspnoea, mitral insufficiency, left ventricle dilatation and lower ejection fraction, haematocrit, and haemoglobin levels than patients with CAF.</p>

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New insight into anomalies of coronary arteries in children: diagnosis, treatment with perioperative and postoperative course and prognosis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月10日

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  • Kamila Kurkiewicz-Sawczak,
  • Filip Baszkowski,
  • Filip Sawczak,
  • Malwina Baturo,
  • Kinga Walska-Świerc,
  • Rafał Surmacz,
  • Dominika Wysocka,
  • Marta Kałużna-Oleksy,
  • Waldemar Bobkowski

摘要

Background

Coronary artery anomalies (CAAs) are rare and heterogeneous congenital abnormalities. However, some of them are associated with serious consequences, including myocardial ischemia, heart failure, and even death. This study aimed to characterize symptoms, course, treatment, and prognosis of different types of CAAs.

Methods

This single-centre retrospective cohort study included 38 consecutive paediatric patients hospitalised in the Department of Paediatric Cardiology due to a diagnosis of CAAs between 01.2012–03.2025. Patients were divided into two groups: anomalous origin of the coronary arteries (Origin anomalies) and coronary artery fistulae (CAF), respectively, 20 and 18 patients. The collected data included clinical symptoms, laboratory tests, electrocardiography, echocardiographic parameters, course of treatment and long-term follow-up.

Results

The mean age of the analysed group was 3.32 ± 5.35 years (range: 1 day − 16 years; IQR0-4.25). The study group included 42% males. During the follow-up, no patient died. There were significant differences between groups in the occurrence of dyspnoea (p < 0.001), cyanosis (p = 0.048), echocardiographic parameters: mitral insufficiency (p = 0.001), left ventricle dilatation (p < 0.001), left ventricular end diastolic diameter z-score (p = 0.023) and end systolic diameter z-score (p = 0.004) and lower ejection fraction (p = 0.001), which was more prevalent in the origin anomalies group than in the CAF group. Moreover, lower haemoglobin (p = 0.006) and haematocrit (p = 0.005) were observed in the origin anomalies group compared to the CAF group.

Conclusions

Our study showed that prompt diagnosis and treatment, including transcatheter or surgical intervention, were associated with clinical improvement and no mortality observed during the follow-up period in the study group. Symptoms like dyspnoea, cyanosis, syncope, no weight gain, feeding disorder and fatigue, especially in younger children, should prompt us to expand the diagnosis and look for diseases such as CAAs. Additionally, patients with origin anomalies had more frequent cyanosis, dyspnoea, mitral insufficiency, left ventricle dilatation and lower ejection fraction, haematocrit, and haemoglobin levels than patients with CAF.