Anomalous coronary arteries

Coronary artery anomalies have been recognized since antiquity and were described in various anatomical treatises by Renaissance scholars. In the mid-1970s, the clinical significance of anomalies of coronary artery origin and course with respect to sudden death was appreciated, and the first successful surgical unroofing procedure was performed. This chapter describes the embryology and normal anatomy of the coronary arteries and types of coronary artery anomalies and their classification. In particular, it discusses the anomalous aortic origin of a coronary artery (AAOCA), diagnosis of AAOCA, and indications for, types, and outcomes of surgical repair for AAOCA.