The first multicentre study on coronary anomalies in the Netherlands: MuSCAT.

Autor: Koppel CJ; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Driesen BW; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., de Winter RJ; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Amsterdam University Medical Centres, location AMC, Amsterdam Zuidoost, The Netherlands., van den Bosch AE; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands., van Kimmenade R; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands., Wagenaar LJ; Thorax Centre Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Jukema JW; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Hazekamp MG; Department of Cardiothoracic Surgery, Leiden University Medical Centre, Leiden, The Netherlands., van der Kley F; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Jongbloed MRM; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands.; Department of Anatomy and Embryology, Leiden University Medical Centre, Leiden, The Netherlands., Kiès P; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Egorova AD; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Verheijen DBH; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands., Damman P; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands., Schoof PH; Department of Cardiothoracic Surgery, Universitair Medisch Centrum Utrecht, Utrecht, The Netherlands., Wilschut J; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands., Stoel M; Thorax Centre Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Speekenbrink RGH; Thorax Centre Twente, Medisch Spectrum Twente, Enschede, The Netherlands., Voskuil M; Department of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands., Vliegen HW; Department of Cardiology, CAHAL, Centre for Congenital Heart Disease Amsterdam-Leiden, Leiden University Medical Centre, Leiden, The Netherlands. h.w.vliegen@lumc.nl.
Jazyk: angličtina
Zdroj: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation [Neth Heart J] 2021 Jun; Vol. 29 (6), pp. 311-317. Date of Electronic Publication: 2021 Mar 08.
DOI: 10.1007/s12471-021-01556-9
Abstrakt: Background: Current guidelines on coronary anomalies are primarily based on expert consensus and a limited number of trials. A gold standard for diagnosis and a consensus on the treatment strategy in this patient group are lacking, especially for patients with an anomalous origin of a coronary artery from the opposite sinus of Valsalva (ACAOS) with an interarterial course.
Aim: To provide evidence-substantiated recommendations for diagnostic work-up, treatment and follow-up of patients with anomalous coronary arteries.
Methods: A clinical care pathway for patients with ACAOS was established by six Dutch centres. Prospectively included patients undergo work-up according to protocol using computed tomography (CT) angiography, ischaemia detection, echocardiography and coronary angiography with intracoronary measurements to assess anatomical and physiological characteristics of the ACAOS. Surgical and functional follow-up results are evaluated by CT angiography, ischaemia detection and a quality-of-life questionnaire. Patient inclusion for the first multicentre study on coronary anomalies in the Netherlands started in 2020 and will continue for at least 3 years with a minimum of 2 years of follow-up. For patients with a right or left coronary artery originating from the pulmonary artery and coronary arteriovenous fistulas a registry is maintained.
Results: Primary outcomes are: (cardiac) death, myocardial ischaemia attributable to the ACAOS, re-intervention after surgery and intervention after initially conservative treatment. The influence of work-up examinations on treatment choice is also evaluated.
Conclusions: Structural evidence for the appropriate management of patients with coronary anomalies, especially (interarterial) ACAOS, is lacking. By means of a structured care pathway in a multicentre setting, we aim to provide an evidence-based strategy for the diagnostic evaluation and treatment of this patient group.
Databáze: MEDLINE
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