Anomalous Aortic Origin of the Coronary Arteries (AAOCA) is a rare congenital disease characterized by an anomalous origin and course of one or both coronaries. AAOCA can express itself in different variants, and each of these may cause myocardial ischemia and subsequent sudden death during physical and sport activity. The diagnosis and ischemic risk stratification is highly complex: not only symptoms are often absent, but also stress tests fail to induce ischemia or related signs, showing in most patients negative results. A correct risk stratification will help the clinician to make a more precise evaluation, to improve treatment guidelines, to finally help patients to return to normal life providing physical activity safety boundaries.

Moved by such considerations, the goal of NECESSARY is to assess the risk of myocardial ischemia in AAOCA patients through patient-specific biomechanical modeling. Indeed, we believe that the only possible way to investigate coronary blood supply and myocardial oxygen demand under intense physical effort, without putting the subject at risk, is a patient-specific computer simulation of aortic root and coronary artery able to virtually reproduce the vascular deformation, the blood pressure, the blood flow, and the oxygen demand, experienced during intense physical effort.

The institutions involved in the research project are the Congenital Cardiac Surgery, the Radiology Unit, the Clinical and Interventional Cardiology of Policlinico San Donato, and the Department of Civil Engineering and Architecture (DICAr) of University of Pavia, respectively represented by Dr. Mauro Lo Rito and Prof. Michele Conti.

FUNDING. This work is funded by the Ministry of Health through the Ricerca Finalizzata project no. GR-2019-12369116. 

The research activity is supported also by the ONLUS association #findtheorange through the CHT (Center for Health Technologies) of the University of Pavia.