Management Implications for Anomalous Aortic Origin of Coronary Arteries.

T he report by Lorber et al. (1) in this issue of iJACC is a large, important, and timely review of the ultrasound diagnosis and delineation of clinically pertinent characteristics in 159 pediatric patients with anomalous aortic origin of the coronary artery (AAOCA), including 89 who underwent surgical revision. Patients were managed at 24 institutions. Ultrasound interpretations by the individual hospital laboratories were compared with reinterpretation by a central expert core laboratory, and then, in those undergoing surgery, with intraoperative findings. Significant discrepancy as well as deficiency of data pertinent to patient management were found between the individual and the core laboratory evaluations, and between both, and intraoperative surgical evaluation. The study provides helpful practical detailed diagnostic and delineation