冠状动脉解剖变异及其狭窄病变的介入治疗

Anatomic variations of coronary artery and the interventional therapy of its stenotic diseases

目的分析国人冠状动脉解剖变异情况及检出率,总结对起源异常的冠状动脉狭窄行介入治疗的体会。方法回顾性总结2010年在我中心接受冠状动脉造影检查的3015例患者,分析42例解剖异常的冠状动脉,总结5例起源异常合并狭窄冠状动脉的经皮冠状动脉介入治疗(PCI)。结果 3015例冠状动脉造影(CAG)患者中检出解剖变异占1.39%(42例),其中冠状动脉起源异常占0.93%(28例),冠状动脉肺动脉瘘占0.27%(8例),冠状动脉左室瘘占0.07%(2例),冠状动脉右室瘘占0.07%(2例),冠状动脉左房瘘占0.03%(1例),冠状动静脉瘘占0.03%(1例)。5例行PCI手术,4例成功,1例术中放弃,未发生严重并发症。结论对起源异常冠状动脉合并狭窄病变进行PCI是安全可行的。

Objective To explore the incidence of anatomic variations of the coronary arteries in Chinese and sum up the experience of interventional therapy to the anomalous origin coronary artery with stenosis. Methods We reviewed 3015 patients undergone coronary angiography（CAG） in 2010, analyzed 42 anatomic variations of coronary artery, and summed up percutaneous coronary intervention （PCI） on 5 patients of anomalous origin coronary artery with stenosis. Results Among all patients undergone CAG, 42 cases had anatomic variation, with an incidence of 1.39%. Anomalous origin coronary artery appeared in 28 cases （0.93%）, coronary pulmonary-artery fistula appeared in 8 cases （0.27%）, the left ventricular fistula in 2 cases （0.07%）, the fight ventricular fistula in 2 cases （0.07%）, the left atrium fistula in 1 case （0.03%）, and the arteriovenous fistula in 1 case（0.03%）. PCI was performed successfully in 4 cases, failed in 1 case, and no major complication happened. Conclusions PCI to the patients of anomalous origin coronary artery with stenosis is safe and feasible.