冠状动脉造影明确冠状动脉起源异常的发生率及分类

The incidence and classification of anomalous origin of coronary artery were confirmed by coronary angiography

目的探讨冠状动脉异常起源及分类。方法回顾性分析 21 215例吉林大学白求恩第一医院行冠状动脉造影检查患者的冠状动脉造影影像。结果在21 215例患者中,冠状动脉起源异常者为 81例,发生率为0.4%。右冠状动脉起源异常共70例,占冠状动脉起源异常总数86.4%,其中62例(76.5%)为右冠状动脉开口于左冠状窦,4例(4.9%)右冠状动脉开口于无冠状窦,1例(1.2%)为右冠状动脉开口于左前降支,1例(1.2%)为右冠状动脉开口于升主动脉,2例(2.5%)为右冠状动脉开口于冠状窦上方。左冠状动脉起源异常共11例,占冠状动脉起源异常总数13.6%,其中3例(3.7%)为左冠状动脉开口于右冠状窦;3例(3.7%)为左回旋支开口于右冠状动脉;1例(1.2%)为左回旋支开口于右冠状窦下方;1例(1.2%)为无左主干,左前降支与左回旋支开口于左冠状窦;2例(2.5%)为无左主干,左前降支与左回旋支开口于主动脉;1例(1.2%)为无左主干,左前降支开口于左冠状窦、左回旋支开口于右冠状窦。结论在冠状动脉起源异常中,右冠状动脉起源异常较常见,其中右冠状动脉开口于左冠状窦最为常见。在冠状动脉造影时,起源异常的冠状动脉其走行也可发生变化。对于冠状动脉起源异常且走行在主-肺动脉之间的冠状动脉异常者,可考虑行手术治疗。

Objective To explore the origin and classifi cation of coronary ostium. Methods We retrospectively analyzed 21 215 coronary angiogram and summarized the feature of anomalous coronary ostium. Results Among the 21 215 cases’coronary angiogram,81 cases with anomalous origin of coronary artery were found. Among the 81 cases,62 cases presented with the anomalous right coronary artery arising at the left sinus of Valsalve, accounting for 76.5% of the all variation,and only 4.9% cases’ right coronary artery were from the non-coronary sinus. The anomalous origin of left coronary artery accounted for 13.6% of the total. Conclusions The anomalous origin of right coronary artery is much more common than that of left coronary artery,among which the right coronary artery arising from left sinus is the most common variation. Besides,we found that the route of coronary arteries with abnormal origin could also change in the coronary angiogram, and the malignant variation such as coronary artery going between aorta and pulmonary artery could be considered for surgical treatment.