5. POLÍTICA MONETARIA DE LA UNIÓN EUROPEA (UE)
5.3. El Banco Central Europeo ante la crisis financiera
5.3.2. Medidas no convencionales
The current study has several limitations. First, this is a retrospective study of prospectively gathered data. However, all patients were clinically referred for CTA, regardless of the presence of chest pain symptoms and CTA was performed using the same protocol, mak- ing a reliable comparison feasible. Secondly, the present patient population is relatively small. Still, data on coronary anatomy in adult patients after ASO are scarce and as only adult patients after ASO were included in the current study, the mean ages of this patient population was relatively high. Thirdly, although these angled origins may be potential risk locations for the development of future ostial coronary lesions causing limitations in coronary blood flow ,the clinical significance of the described abnormal coronary find- ings, mainly the presence of an acute angle of the coronary origin, remains uncertain. Importantly, to our best knowledge this is the first study proposing a pathophysiological relation between the observed coronary anatomy and the neo-aorta root dimensions in adult patients late after ASO.
ConClusIons and ClInICal ImPlICaTIons
The present study provided detailed information on the coronary anatomy late after the ASO and showed that abnormal coronary findings on CTA are often encountered in adult patients after ASO. Abnormal coronary findings were more frequently observed in patients with a variant coronary anatomy pattern, with a higher occurrence of an acute angle of the coronary origin. Significantly larger neo-aortic root dimensions and higher coronary artery take-off were observed in patients with acute angled coronary origins. Accordingly, these findings could be predictors for the development of an acute angle of the coronary origin during follow-up. The current observations may help explaining the pathophysiology of the ostial coronary lesions that are frequently encountered in patients after ASO. Although the clinical significance of these findings remains uncertain until longer-term follow-up is avail- able, we feel that the lack of symptoms and the potential life-threatening consequences
of coronary flow obstruction may justify repeated imaging, especially in patients with a variant coronary anatomy and/or neo-aortic root dilation since these patients seem to be at increased risk for developing coronary abnormalities.
rEfErEnCEs
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