Anomalous aortic origin of a coronary artery (AAOCA) is treated by the multidisciplinary Coronary Anomalies Program at Texas Children’s Hospital. We are dedicated to the diagnosis and management of patients with congenital coronary anomalies including AAOCA. 

What is anomalous aortic origin of a coronary artery (AAOCA)?

The coronary arteries are vessels that arise from the aorta (the biggest vessel in the body) and provide blood supply to the heart. There are usually two: the left and right coronary arteries. The vessels arise from one of three outpouchings of the aorta called sinuses of valsalva. Anomalous aortic origin of a coronary artery (AAOCA) is a cardiac abnormality present at birth in which the origin or course of a coronary artery that arises from the aorta is atypical.

AAOCA is the second leading cause of sudden cardiac death (SCD) in young athletes in United States.

People with AAOCA are typically asymptomatic. The first manifestation of the disorder can be sudden cardiac arrest (SCA) or SCD in nearly half of those affected with certain types of this condition.

Figure 1. Normal anatomy of the coronary arteries on ectoscopy

Normal anatomy of the origin of the coronary arteries


  • Anomalous Right Coronary Artery (ARCA) (Figure 2)
  • Anomalous Left Coronary Artery (ALCA) (Figure 2)
  • Anomalous Circumflex Coronary Artery (ACCA)

Figure 2. Anatomy of left and right AAOCA.