COMPLEX ISSUES IN CORONARY REVASCULARIZATION: Edited by Bobby Yanagawa and Subodh VermaAnomalous origins of the coronary arteries current knowledge and future perspectivesMazine, Aminea; Fernandes, Ian M.b; Haller, Christopha; Hickey, Edward J.a Author Information aDepartment of Surgery, Division of Cardiovascular Surgery, University of Toronto, The Hospital for Sick Children bDepartment of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada Correspondence to Edward J. Hickey, MD, The Hospital for Sick Children, 555 University Ave., Toronto, ON, Canada M5G 1X8. E-mail: [email protected] Current Opinion in Cardiology: September 2019 - Volume 34 - Issue 5 - p 543-551 doi: 10.1097/HCO.0000000000000663 Buy Metrics Abstract Purpose of review The purpose of this review is to survey the contemporary literature surrounding congenital anomalies of origin of the coronary arteries and to identify remaining gaps in knowledge. Recent findings In recent years, lineage tracing analyses and mechanistic studies in model organisms have enhanced our understanding of the normal embryologic development of the coronary arteries, and how disruption of this intricate process can lead to congenital coronary anomalies. The true incidence of these anomalies remains unknown. Although a majority of cases are believed to be clinically silent, clinical presentation varies widely, from asymptomatic to sudden cardiac death. Cardiac computed tomography angiography and/or magnetic resonance angiography are the mainstay diagnostic modalities. Management of anomalous coronary arteries depends on the morphology and clinical presentation. Surgery is the gold-standard treatment for anomalous left coronary artery arising from the pulmonary artery and anomalous aortic origin of a coronary artery with intramural or interarterial course. Summary Several large multicenter initiatives are currently underway and should help address some of the numerous knowledge gaps surrounding the evaluation and management of anomalous coronary arteries. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.