冠状动脉起源异常29例

Coronary artery origin anomalies:analysis of 29 cases.

目的 了解冠状动脉起源异常 ( coronary artery origin anomalies,CAOA)的情况。方法 回顾性分析我院从1995至 2 0 0 1年 2 4 16例冠状动脉造影结果。结果 CAOA2 9例 ( 1.2 % ) ,其中左前降支 ( L AD)和回旋支 ( L CX)分别独立起源于左冠状窦 17例 ( 5 8.6% ) ,右冠 ( RCA)起源于左冠状窦 6例 ( 2 0 .7% ) ,RCA起源于升主支脉 1例 ( 3 .4 % ) ,L CX起源于右冠状窦 4例 ( 13 .8% ) ,L CX起源于 RCA 1例 ( 3 .4 % ) ;2 9例患者中除 5例 ( 17.2 % )合并有冠状动脉狭窄外 ,其余 2 4例 ( 82 .8% )患者未见冠状动脉狭窄。结论 CAOA是影响冠状动脉造影的因素之一 ,但仔细观察左心室造影结果 ,选用不同型号的造影导管 ,终能满意地显示冠状动脉。最常见的类型是 L AD和 L CX分别独立起源于左冠状窦 ,大多数异常类型并不导致严重的临床症状 。

Objective To gain an understanding of the coronary artery origin anomalies(CAOA).Methods The data on 2416 cases of coronary arteriography at our hospital from 1995 to 2001 were reviewed and analyzed.Results CAOA were confirmed in 29 patients(1.2%).The incidence for separate origin of LAD and LCX from the left sinus of Valsalva(58.6%)was the highest.RCA was found originating from the left sinus of Valsalva in 6(20.7%),from the ascending aorta in 1( 3.4 %).Anomalous LCX from right sinus of Valsalva was seen in 4(13.8%),and from RCA in 1(3.4%).Only 5(17.2%) patients had coronary stenosis.Conclusion In our caseseries,separate origin of the left anterior descending and circumflex from the left sinus of Valsalva was the commonest coronary artery origin anomalies.It does not appear to be an increased risk for the development of atherosclerotic coronary artery disease in anomalous coronary arteries.Only a few cases of coronary artery anomalies require surgical correction.