LAUSR

ACCA was first described by Antopol and Kugel.3 The prevalence of ACCA reported in the coronary angiography literature ranges from 0.18% to 0.67%, making it the most common CAA. Some authors postulate that the oblique angulation of its origin predisposes ACCA to atherosclerosis. However, most clinicians agree that ACCA is a benign, asymptomatic anomaly. Indeed, the retroaortic course of ACCA, as described by the aortic root sign, rarely leads to ischemia or sudden cardiac death. On the contrary, CAAs that travel along an interarterial course between the aorta and pulmonary artery are more prone to ischemia during strenuous exercise.2