Rigatelli Gianluca, Rigatelli Giorgio
Division of Cardiology, Department of Specialistic Medicine, Mater Salutis Legnago General Hospital, Legnago, VR, Italy.
Ital Heart J. 2003 May;4(5):305-10.
The anatomic details and pathophysiological patterns of most coronary artery anomalies (CAAs) are presently well known. On the contrary, few data exist on the clinical relevance of different CAAs which necessitate a proper management and follow-up protocol. Clinical, invasive and interventional cardiologists often continue to encounter CAAs as incidental findings during routine diagnostic work up for other cardiac diseases and are sometimes unable to fit them into a specific pathophysiological context and a corresponding management protocol. In describing CAAs the authors have focused their attention on the clinical relevance in order to suggest a practical clinical classification based on four classes of clinical significance: I-benign, II-relevant (related to myocardial ischemia), III-severe (related to sudden death), IV-critical (association of classes II and III with superimposed coronary artery disease).
目前，大多数冠状动脉异常（CAA）的解剖细节和病理生理模式已为人熟知。相反，关于不同CAA的临床相关性的数据却很少，这就需要一个恰当的管理和随访方案。临床心脏病专家、介入心脏病专家在对其他心脏疾病进行常规诊断检查时，经常会偶然发现CAA，有时无法将其纳入特定的病理生理背景及相应的管理方案中。在描述CAA时，作者将注意力集中在临床相关性上，以便提出一种基于四类临床意义的实用临床分类：I类-良性，II类-相关（与心肌缺血相关），III类-严重（与猝死相关），IV类-危急（II类和III类与叠加的冠状动脉疾病相关）。
