CLINICAL STUDIES
Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes
Cristina Basso, MD, PhD*,
Barry J. Maron, MD, FACC ,
Domenico Corrado, MD and
Gaetano Thiene, MD*
* Department of Pathology, University of Padua Medical School, Padua, Italy
Department of Cardiology, University of Padua Medical School, Padua, Italy
Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
Manuscript received October 1, 1999;
revised manuscript received November 16, 1999,
accepted January 7, 2000.
Reprint requests and correspondence: Dr. Cristina Basso, Cardiovascular Pathology, University of Padua Medical School, Via A. Gabelli, 61, Padua, Italy
OBJECTIVES
The purpose of this study is to characterize the clinical profile and identify clinical markers that would enable the detection during life of anomalous coronary artery origin from the wrong aortic sinus (with course between the aorta and pulmonary trunk) in young competitive athletes.
BACKGROUND
Congenital coronary artery anomalies are not uncommonly associated with sudden death in young athletes, the catastrophic event probably provoked by myocardial ischemia. Such coronary anomalies are rarely identified during life, often because of insufficient clinical suspicion. However, since anomalous coronary artery origin is amenable to surgical treatment, timely clinical identification is crucial.
METHODS
Because of the paucity of available data characterizing the clinical profile of wrong sinus coronary artery malformations, we reviewed two large registries comprised of young competitive athletes who died suddenly, assembled consecutively in the U.S. and Italy.
RESULTS
We reported 27 sudden deaths in young athletes, identified solely at autopsy and due to either left main coronary artery from the right aortic sinus (n = 23) or right coronary artery from the left sinus (n = 4). Each athlete died either during (n = 25) or immediately after (n = 2) intense exertion on the athletic field. Fifteen athletes (55%) had no clinical cardiovascular manifestations or testing during life. However, in the remaining 12 athletes (45%) aged 16 ± 7, certain clinical data were available. Premonitory symptoms had occurred in 10, including syncope in four (exertional in three and recurrent in two, 3 to 24 months before death) and chest pain in five (exertional in three, all single episodes,  24 months before death). All cardiovascular tests were within normal limits, including 12-lead electrocardiogram (ECG) pattern (in 9/9), stress ECG with maximal exercise (in 6/6) and left ventricular wall motion and cardiac dimensions by two-dimensional echocardiography (in 2/2).
CONCLUSIONS
With regard to congenital coronary artery anomalies of wrong aortic sinus origin in young competitive athletes, 1) standard testing with ECG under resting or exercise conditions is unlikely to provide clinical evidence of myocardial ischemia and would not be reliable as screening tests in large athletic populations, 2) premonitory cardiac symptoms not uncommonly occurred shortly before sudden death (typically associated with anomalous left main coronary artery), suggesting that a history of exertional syncope or chest pain requires exclusion of this anomaly. These observations have important implications for the preparticipation screening of competitive athletes.
|
Abbreviations and Acronyms
| | ECG | = electrocardiogram | | LMCA | = left main coronary artery | | RCA | = right coronary artery |
|
This article has been cited by other articles:
|
|
|
|
 
J. E. Davies, H. M. Burkhart, J. A. Dearani, R. M. Suri, S. D. Phillips, C. A. Warnes, T. M. Sundt III, and H. V. Schaff
Surgical management of anomalous aortic origin of a coronary artery.
Ann. Thorac. Surg.,
September 1, 2009;
88(3):
844 - 847.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M Borjesson and A Pelliccia
Incidence and aetiology of sudden cardiac death in young athletes: an international perspective
Br. J. Sports Med.,
September 1, 2009;
43(9):
644 - 648.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N H Prakken, B K Velthuis, M J Cramer, and A Mosterd
Advances in cardiac imaging: the role of magnetic resonance imaging and computed tomography in identifying athletes at risk
Br. J. Sports Med.,
September 1, 2009;
43(9):
677 - 684.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J A Drezner
Preparing for sudden cardiac arrest--the essential role of automated external defibrillators in athletic medicine: a critical review
Br. J. Sports Med.,
September 1, 2009;
43(9):
702 - 707.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C Schmied, Y Zerguini, A Junge, P Tscholl, A Pelliccia, B M Mayosi, and J Dvorak
Cardiac findings in the precompetition medical assessment of football players participating in the 2009 African Under-17 Championships in Algeria
Br. J. Sports Med.,
September 1, 2009;
43(9):
716 - 721.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. D. Reich
Pre-participation sports clearance.
J. Am. Coll. Cardiol.,
June 16, 2009;
53(24):
2310 - 2310.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, D. Zipes, and A. Pelliccia
Reply
J. Am. Coll. Cardiol.,
June 16, 2009;
53(24):
2311 - 2311.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Corrado, C. Basso, M. Schiavon, A. Pelliccia, and G. Thiene
Reply
J. Am. Coll. Cardiol.,
June 16, 2009;
53(24):
2310 - 2311.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R M Campbell, S Berger, and J Drezner
Sudden cardiac arrest in children and young athletes: the importance of a detailed personal and family history in the pre-participation evaluation
Br. J. Sports Med.,
May 1, 2009;
43(5):
336 - 341.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, J. J. Doerer, T. S. Haas, D. M. Tierney, and F. O. Mueller
Sudden Deaths in Young Competitive Athletes: Analysis of 1866 Deaths in the United States, 1980-2006
Circulation,
March 3, 2009;
119(8):
1085 - 1092.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.A. Brothers, M.G. McBride, B.S. Marino, R.S. Tomlinson, M.A. Seliem, M.H. Pampaloni, J.W. Gaynor, T.L. Spray, and S.M. Paridon
Exercise performance and quality of life following surgical repair of anomalous aortic origin of a coronary artery in the pediatric population.
J. Thorac. Cardiovasc. Surg.,
February 1, 2009;
137(2):
380 - 384.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Corrado, C. Basso, A. Pelliccia, and G. Thiene
CHAPTER 32 Sports and Heart Disease
ESC Textbook of Cardiovascular Medicine,
January 1, 2009;
2(1):
med-9780199566990-chapter - med-9780199566990-chapter.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease) Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
J. Am. Coll. Cardiol.,
December 2, 2008;
52(23):
e143 - e263.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. A. Warnes, R. G. Williams, T. M. Bashore, J. S. Child, H. M. Connolly, J. A. Dearani, P. del Nido, J. W. Fasules, T. P. Graham Jr, Z. M. Hijazi, et al.
ACC/AHA 2008 Guidelines for the Management of Adults With Congenital Heart Disease: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease): Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons
Circulation,
December 2, 2008;
118(23):
e714 - e833.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Natarajan
Cardiac computed tomography to visualize typical variants of the right-sided origin of the left main coronary artery.
J. Am. Coll. Cardiol. Img.,
November 1, 2008;
1(6):
815 - 816.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M.-S. Kupper, N. Bethuyne, J. Rubay, F. Verhelst, C. Barrea, and S. Moniotte
Aberrant left coronary artery arising from the right sinus of Valsalva: Case reports of a rare entity
J. Thorac. Cardiovasc. Surg.,
September 1, 2008;
136(3):
788 - 789.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Ropers, D. C. Soon Ping, and S. Achenbach
Right-sided origin of the left main coronary artery: typical variants and their visualization by cardiac computerized tomography.
J. Am. Coll. Cardiol. Img.,
September 1, 2008;
1(5):
679 - 681.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Brothers, P. Stephens, J. W. Gaynor, R. Lorber, L. A. Vricella, and S. M. Paridon
Anomalous Aortic Origin of a Coronary Artery With an Interarterial Course: Should Family Screening Be Routine?
J. Am. Coll. Cardiol.,
May 27, 2008;
51(21):
2062 - 2064.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Cheitlin
Finding Asymptomatic People With a Coronary Artery Arising From the Wrong Sinus of Valsalva: Consequences Arising From Knowing the Anomaly to Be Familial
J. Am. Coll. Cardiol.,
May 27, 2008;
51(21):
2065 - 2067.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Boissier, N. Coolen, P. Nataf, and D. Tchetche
Sudden Death Related to an Anomalous Origin of the Right Coronary Artery
Ann. Thorac. Surg.,
March 1, 2008;
85(3):
1077 - 1079.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Brothers, M. G. McBride, M. A. Seliem, B. S. Marino, R. S. Tomlinson, M. H. Pampaloni, J. W. Gaynor, T. L. Spray, and S. M. Paridon
Evaluation of Myocardial Ischemia After Surgical Repair of Anomalous Aortic Origin of a Coronary Artery in a Series of Pediatric Patients
J. Am. Coll. Cardiol.,
November 20, 2007;
50(21):
2078 - 2082.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. M. Gersony
Management of Anomalous Coronary Artery From the Contralateral Coronary Sinus
J. Am. Coll. Cardiol.,
November 20, 2007;
50(21):
2083 - 2084.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. Gulati, V. M. Reddy, C. Culbertson, G. Helton, S. Suleman, O. Reinhartz, N. Silverman, and F. L. Hanley
Surgical management of coronary artery arising from the wrong coronary sinus, using standard and novel approaches.
J. Thorac. Cardiovasc. Surg.,
November 1, 2007;
134(5):
1171 - 1178.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Koestenberger, B. Nagel, A. Gamillscheg, W. Temmel, G. Cvirn, and A. Beitzke
Myocardial Infarction in an Adolescent: Anomalous Origin of the Left Main Coronary Artery From the Right Coronary Sinus in Association With Combined Prothrombotic Defects
Pediatrics,
August 1, 2007;
120(2):
e424 - e427.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Alphonso, P. V. Anagnostopoulos, L. Nolke, A. Moon-Grady, A. Azakie, G. W. Raff, and T. R. Karl
Anomalous Coronary Artery From the Wrong Sinus of Valsalva: A Physiologic Repair Strategy
Ann. Thorac. Surg.,
April 1, 2007;
83(4):
1472 - 1476.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, P. D. Thompson, M. J. Ackerman, G. Balady, S. Berger, D. Cohen, R. Dimeff, P. S. Douglas, D. W. Glover, A. M. Hutter Jr, et al.
Recommendations and Considerations Related to Preparticipation Screening for Cardiovascular Abnormalities in Competitive Athletes: 2007 Update: A Scientific Statement From the American Heart Association Council on Nutrition, Physical Activity, and Metabolism: Endorsed by the American College of Cardiology Foundation
Circulation,
March 27, 2007;
115(12):
1643 - 1655.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Angelini
Coronary Artery Anomalies: An Entity in Search of an Identity
Circulation,
March 13, 2007;
115(10):
1296 - 1305.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Basavarajaiah, A. Shah, and S. Sharma
Sudden cardiac death in young athletes
Heart,
March 1, 2007;
93(3):
287 - 289.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. M. Campbell and S. Berger
Preventing Pediatric Sudden Cardiac Death: In Reply
Pediatrics,
February 1, 2007;
119(2):
408 - 409.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. K. Attili and P. N. Cascade
CT and MRI of Coronary Artery Disease:Evidence-Based Review.
Am. J. Roentgenol.,
December 1, 2006;
187(6 Suppl):
S483 - S499.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. K. Attili, J. M. Foral, U. J. Schoepf, P. N. Cascade, and F. S. Chew
CT and MRI of Coronary Artery Disease: Self-Assessment Module
Am. J. Roentgenol.,
December 1, 2006;
187(6_Supplement):
S500 - S504.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron and A. Pelliccia
The Heart of Trained Athletes: Cardiac Remodeling and the Risks of Sports, Including Sudden Death
Circulation,
October 10, 2006;
114(15):
1633 - 1644.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Corrado, C. Basso, A. Pavei, P. Michieli, M. Schiavon, and G. Thiene
Trends in Sudden Cardiovascular Death in Young Competitive Athletes After Implementation of a Preparticipation Screening Program
JAMA,
October 4, 2006;
296(13):
1593 - 1601.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Erez, V. K.H. Tam, N. A. Doublin, and J. Stakes
Anomalous coronary artery with aortic origin and course between the great arteries: improved diagnosis, anatomic findings, and surgical treatment.
Ann. Thorac. Surg.,
September 1, 2006;
82(3):
973 - 977.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Strickberger, D. W. Benson, I. Biaggioni, D. J. Callans, M. I. Cohen, K. A. Ellenbogen, A. E. Epstein, P. Friedman, J. Goldberger, P. A. Heidenreich, et al.
AHA/ACCF Scientific Statement on the Evaluation of Syncope: From the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation In Collaboration With the Heart Rhythm Society
J. Am. Coll. Cardiol.,
January 17, 2006;
47(2):
473 - 484.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. A. Strickberger, D. W. Benson, I. Biaggioni, D. J. Callans, M. I. Cohen, K. A. Ellenbogen, A. E. Epstein, P. Friedman, J. Goldberger, P. A. Heidenreich, et al.
AHA/ACCF Scientific Statement on the Evaluation of Syncope: From the American Heart Association Councils on Clinical Cardiology, Cardiovascular Nursing, Cardiovascular Disease in the Young, and Stroke, and the Quality of Care and Outcomes Research Interdisciplinary Working Group; and the American College of Cardiology Foundation: In Collaboration With the Heart Rhythm Society: Endorsed by the American Autonomic Society
Circulation,
January 17, 2006;
113(2):
316 - 327.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. E. Paterick, T. J. Paterick, G. F. Fletcher, and B. J. Maron
Medical and Legal Issues in the Cardiovascular Evaluation of Competitive Athletes
JAMA,
December 21, 2005;
294(23):
3011 - 3018.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, P. S. Douglas, T. P. Graham, R. A. Nishimura, and P. D. Thompson
Task Force 1: Preparticipation screening and diagnosis of cardiovascular disease in athletes
J. Am. Coll. Cardiol.,
April 19, 2005;
45(8):
1322 - 1326.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. P. Graham Jr, D. J. Driscoll, W. M. Gersony, J. W. Newburger, A. Rocchini, and J. A. Towbin
Task Force 2: Congenital heart disease
J. Am. Coll. Cardiol.,
April 19, 2005;
45(8):
1326 - 1333.
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Corrado, A. Pelliccia, H. H. Bjornstad, L. Vanhees, A. Biffi, M. Borjesson, N. Panhuyzen-Goedkoop, A. Deligiannis, E. Solberg, D. Dugmore, et al.
Cardiovascular pre-participation screening of young competitive athletes for prevention of sudden death: proposal for a common European protocol: Consensus Statement of the Study Group of Sport Cardiology of the Working Group of Cardiac Rehabilitation and Exercise Physiology and the Working Group of Myocardial and Pericardial Diseases of the European Society of Cardiology
Eur. Heart J.,
March 1, 2005;
26(5):
516 - 524.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. E. Eckart, S. L. Scoville, C. L. Campbell, E. A. Shry, K. C. Stajduhar, R. N. Potter, L. A. Pearse, and R. Virmani
Sudden Death in Young Adults: A 25-Year Review of Autopsies in Military Recruits
Ann Intern Med,
December 7, 2004;
141(11):
829 - 834.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. R. Deibler, R. S. Kuzo, M. Vohringer, E. E. Page, R. E. Safford, J. N. Patton, G. E. Lane, R. L. Morin, and T. C. Gerber
Imaging of Congenital Coronary Anomalies With Multislice Computed Tomography
Mayo Clin. Proc.,
August 1, 2004;
79(8):
1017 - 1023.
[Abstract]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, B. R. Chaitman, M. J. Ackerman, A. Bayes de Luna, D. Corrado, J. E. Crosson, B. J. Deal, D. J. Driscoll, N.A. M. Estes III, C. G. S. Araujo, et al.
Recommendations for Physical Activity and Recreational Sports Participation for Young Patients With Genetic Cardiovascular Diseases
Circulation,
June 8, 2004;
109(22):
2807 - 2816.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Corrado, C. Basso, G. Rizzoli, M. Schiavon, and G. Thiene
Does sports activity enhance the risk of sudden death in adolescents and young adults?
J. Am. Coll. Cardiol.,
December 3, 2003;
42(11):
1959 - 1963.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron
Sudden Death in Young Athletes
N. Engl. J. Med.,
September 11, 2003;
349(11):
1064 - 1075.
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. L. Romp, J. R. Herlong, C. K. Landolfo, S. P. Sanders, C. E. Miller, R. M. Ungerleider, and J. Jaggers
Outcome of unroofing procedure for repair of anomalous aortic origin of left or right coronary artery
Ann. Thorac. Surg.,
August 1, 2003;
76(2):
589 - 596.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G Casolo, G F Gensini, G Santoro, and L Rega
Anomalous origin of the circumflex artery and patent foramen ovale: a rare cause of myocardial ischaemia after percutaneous closure of the defect
Heart,
August 1, 2003;
89(8):
e23 - 23.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. S. Batra and A. R. Hohn
Consultation with the Specialist: Palpitations, Syncope, and Sudden Cardiac Death in Children: Who's at Risk?
Pediatr. Rev.,
August 1, 2003;
24(8):
269 - 275.
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. J. Maron, K. P. Carney, H. M. Lever, J. F. Lewis, I. Barac, S. A. Casey, and M. V. Sherrid
Relationship of race to sudden cardiac death in competitive athletes with hypertrophic cardiomyopathy
J. Am. Coll. Cardiol.,
March 19, 2003;
41(6):
974 - 980.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
N. Goldschlager, A. E. Epstein, B. P. Grubb, B. Olshansky, E. Prystowsky, W. C. Roberts, M. M. Scheinman, and for the Practice Guidelines Subcommittee, North Am
Etiologic Considerations in the Patient With Syncope and an Apparently Normal Heart
Arch Intern Med,
January 27, 2003;
163(2):
151 - 162.
[Full Text]
[PDF]
|
|
|
|
|
|
|
P. Angelini, J. A. Velasco, and S. Flamm
Coronary Anomalies: Incidence, Pathophysiology, and Clinical Relevance
Circulation,
May 21, 2002;
105(20):
2449 - 2454.
[Full Text]
[PDF]
|
|
|
|
|
|
|
Y. Misawa, T. Saito, S.-i. Oki, and K. Fuse
Management of anomalous right coronary arteries encountered during aortic valve surgery
Eur. J. Cardiothorac. Surg.,
January 1, 2002;
21(1):
102 - 104.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. D. Rodefeld, C. B. Culbertson, H. M. Rosenfeld, F. L. Hanley, and L. D. Thompson
Pulmonary artery translocation: a surgical option for complex anomalous coronary artery anatomy
Ann. Thorac. Surg.,
December 1, 2001;
72(6):
2150 - 2152.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. M. Morphet
Congenital coronary artery anomalies: diagnosable, premortem?
J. Am. Coll. Cardiol.,
November 1, 2001;
38(5):
1587 - 1588.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. K. L. Phoon
Management of anomalous coronary artery
J. Am. Coll. Cardiol.,
October 1, 2001;
38(4):
1269 - 1270.
[Full Text]
[PDF]
|
|
|
|
|
|
|
S.G. Priori, E. Aliot, C. Blomstrom-Lundqvist, L. Bossaert, G. Breithardt, P. Brugada, A.J. Camm, R. Cappato, S.M. Cobbe, C. Di Mario, et al.
Task Force on Sudden Cardiac Death of the European Society of Cardiology
Eur. Heart J.,
August 2, 2001;
22(16):
1374 - 1450.
[PDF]
|
|
|
|
|
|
|
J. A. Davis, F. Cecchin, T. K. Jones, and M. A. Portman
Major coronary artery anomalies in a pediatric population: incidence and clinical importance
J. Am. Coll. Cardiol.,
February 1, 2001;
37(2):
593 - 597.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Pelliccia
Congenital coronary artery anomalies in young patients: New perspectives for timely identification
J. Am. Coll. Cardiol.,
February 1, 2001;
37(2):
598 - 600.
[Full Text]
[PDF]
|
|
|
|
