成年人冠状动脉造影先天性变异分析

Analysis of Congenital Coronary Artery Anomalies Identified by Coronary Arteriography in Adults

目的 :探讨成年人先天性冠状动脉变异 (畸形 )的检出频度。 方法 :回顾性研究总结 4173例患者的冠状动脉造影资料 ,准确判定各种先天性冠状动脉变异。 结果 :1冠状动脉造影 4173例中检出冠状动脉开口起源异常 5 0例 ,检出率为 1.2 % ,其中各种右冠状动脉起源异常 42例 ,占 84.0 % ,左冠状动脉起源异常 7例 ,占 14.0 % ,左、右冠状动脉开口起源均异常 1例 ,占 2 .0 % ;2检出各种类型冠状动脉分支起源异常 15例 ,检出率为 0 .4% ;3检出各种类型冠状动脉瘘 2 8例 ,检出率为 0 .7% ,其中 18例(6 4.3% )为冠状动脉—肺动脉瘘 ;4其它少见冠状动脉变异 2例。 结论 :成年人先天性冠状动脉变异的临床症状和体征多不典型或缺如 ,通常在心导管检查中被偶然发现 ,冠状动脉造影是确诊各种类型冠状动脉变异最重要的检查方法。

Objective:To study the detection rate of congenital anomalies of coronary artery in adults. Methods:The catheterization data of 4 173 patients undergone coronary arteriography (CAG) were retrospectively reviewed,and patients with congenital coronary artery anomalies were identified precisely. Results:①Among the 4 173 patients,50 cases were found to have anomalous origin of the coronary artery,with a detection rate of 1 2%,of which,42 cases (84 0%) had anomalous origin of right coronary artery,7 cases (14 0%) of left coronary artery,and one case (2 0%) of both left and right coronary arteries.②Fifteen cases were found to have anomalous origin of the branch of coronary artery,with a detection rate of 0 4%.③Twenty eight cases were found to have coronary fistulae,with a detection rate of 0 7%,of which,18 cases (64 3%) with fistulae drained into the pulmonary artery.④Two cases had rare anomalies of coronary artery. Conclusion:Most of the congenital coronary anomalies identified in adults present either atypical or no signs and symptoms,and are usually found accidentally during catheterization.CAG is the most important method for accurate diagnosis of various types of coronary artery anomalies.