Chaitman B R, Lespérance J, Saltiel J, Bourassa M G
Circulation. 1976 Jan;53(1):122-31. doi: 10.1161/01.cir.53.1.122.
Clinical and angiographic features of 31 patients with anomalous coronpary artery origin are reviewed. Of 17 aberrant circumflex arteries from the right sinus of Valsalva or artery, each was retro-aortic, six atherosclerotic, and seven irrigated a small area of myocardium. Of seven anomalous right coronary arteries from the left sinus of Valsalva or artery, each was ante-aortic and two atherosclerotic. Aberrant origin of the circumflex or right coronary artery was a benign anomaly. The proximal course of seven aberrant left coronary arteries from the right sinus of Valsalva or right coronary artery was related to clinical events. The anomaly was best demonstrated in the lateral view. In five cases, coronary blood flow during exercise and myocardial metabolism during pacing were assessed. Two had had a previous infarction with nonatherosclerotic arteries. Exercise coronary blood flow was normal in four and low in one patient. Pacing resulted in lactate production in two with atherosclerotic and one without atherosclerotic arteries. We conclude that anomalous left coronpary origin from the right sinus of Valsalva can result in significant myocardial ischemia and infarction.
回顾了31例冠状动脉起源异常患者的临床和血管造影特征。在17条起源于瓦氏窦右侧或动脉的异常回旋支动脉中，每条均走行于主动脉后方，6条有动脉粥样硬化，7条供血小面积心肌。在7条起源于瓦氏窦左侧或动脉的异常右冠状动脉中，每条均走行于主动脉前方，2条有动脉粥样硬化。回旋支或右冠状动脉起源异常是一种良性异常。7条起源于瓦氏窦右侧或右冠状动脉的异常左冠状动脉的近端走行与临床事件相关。该异常在侧位片中显示最佳。在5例患者中，评估了运动时的冠状动脉血流和起搏时的心肌代谢。2例既往有梗死且动脉无动脉粥样硬化。4例运动时冠状动脉血流正常，1例降低。起搏导致2例有动脉粥样硬化和1例无动脉粥样硬化的患者产生乳酸。我们得出结论，起源于瓦氏窦右侧的异常左冠状动脉可导致显著的心肌缺血和梗死。
