Mikaeloff P, Loire R, Amiel M, Saint-Pierre A, Allouache K, Leoni F, Delahaye J P
Arch Mal Coeur Vaiss. 1979 Aug;72(8):895-8.
An anomalous circumflex coronary artery arising from the main right coronary artery is an added risk in mitro-aortic valve replacement. The infortunate history of a patient with an anomalous circumflex artery visualised on pre-operative cineangiography who underwent a double valve replacement is reported. The first 10 post-operative days were uncomplicated with no haemodynamic disturbances. Thereafter, major ventricular arrhythmiad 54th post-operative days) without signs of myocardial infarction, which were responsible for her death. On autopsy a large anomalous circumflex artery arising from the main right coronary artery was shown. In its course, posterior to the aorta, it was literally wedged between the rigid sewing rings of the two prosthetic valves. No thrombus was found within, and there were no myocardial lesions. The only apparent cause of the arrhythmias and death of the patient was the compression of this large circumflex artery.
起源于右冠状动脉主干的异常回旋支冠状动脉是二尖瓣-主动脉瓣置换术的额外风险因素。本文报告了一名术前电影血管造影显示有异常回旋支动脉的患者在接受双瓣置换术后的不幸病史。术后前10天无并发症，无血流动力学紊乱。此后，在术后第54天出现严重室性心律失常，但无心肌梗死迹象，最终导致患者死亡。尸检显示一条粗大的异常回旋支动脉起源于右冠状动脉主干。在其走行过程中，位于主动脉后方，实际上被夹在两个人工瓣膜的刚性缝合环之间。血管内未发现血栓，也无心肌病变。患者心律失常和死亡的唯一明显原因是这条粗大的回旋支动脉受到压迫。
