Our Approach to AAOCA

At Columbia, your child’s care is guided by a team of pediatric heart specialists who work closely together. Pediatric cardiologists, imaging experts, and heart surgeons review each case step by step to make sure nothing is missed and that care is tailored to your child.

Imaging guides treatment

We use several types of heart imaging to understand your child’s coronary arteries and how well blood flows through them.

• An echocardiogram is usually the first test. It helps us look at heart structure and function safely and painlessly.
• Cardiac CT scans are our main tool for finding where the coronary arteries begin, how they travel through the body, and whether there are features that could affect blood flow.
• When needed, cardiac MRI helps us evaluate heart function and heart muscle health without radiation.
• For children who are able, exercise or nuclear stress tests may be used to see how the heart performs during physical activity and whether blood flow is affected during exertion.

3D Modeling & Surgical Planning

At Columbia, we can create detailed three-dimensional models of your child’s heart using imaging data. These models help us clearly see the shape and path of the coronary arteries and how they relate to nearby structures.

For children with more complex anatomy, these models allow surgeons to carefully plan the safest and most precise surgical approach—and help families better visualize and understand the condition.

When Surgery Is Recommended

Surgery may be recommended if symptoms or testing suggest that blood flow to the heart could be limited or if certain high-risk features are present.

This includes symptoms during exercise, abnormal stress test results, or specific anatomical findings such as narrowing of the artery, unusual artery pathways, or areas where the artery runs within the heart muscle. When surgery is needed, the surgical plan is carefully customized to your child’s anatomy.