Kaklikkaya Islam, Yeginoglu Gulay
Department of Thoracic and Cardiovascular Surgery, Karadeniz Technical University, Trabzon, Turkey.
Heart Surg Forum. 2003;6(6):E138-42.
The rheumatic cardiac valve diseases are one of the most important heart problems in Turkey. In mitral valve surgery, the relationship between the anulus fibrosus sinister and the coronary arteries is extremely critical for the postoperative life of the patient.
The study was performed with human adult hearts. The aim of this study of 50 hearts was to understand the existing correlations between the mitral annulus and the coronary arteries. We determined the right or left dominance or codominance of the anulus fibrosus sinister on each heart and stu died the relationship of the mitral annulus to the circumflex coronary artery (CCA) and the left posterior descending coronary artery.
The distances of the anulus fibrosus sinister from the CCA and interventricularis posterior arteries w e re measured with a flexible ruler. In 19 of 50 cases, the distance of the coronary artery from the annulus was 3 mm at 23 different points, 2 mm at 8 different points, and 1 mm at 2 different points.
In mitral valve surgery, damage to the CCA can occur, especially in patients with left coronary dominance or codominance in which the CCA is running in the atrioventricular groove very close to the mitral annulus. Therefore, this study emphasizes the importance of knowing the coronary artery anatomy preoperatively.
风湿性心脏瓣膜病是土耳其最重要的心脏问题之一。在二尖瓣手术中，左纤维环与冠状动脉之间的关系对患者术后生活极为关键。
本研究以成人心脏进行。对50颗心脏进行此项研究的目的是了解二尖瓣环与冠状动脉之间的现有相关性。我们确定了每颗心脏左纤维环的右优势、左优势或共优势，并研究了二尖瓣环与回旋支冠状动脉（CCA）和左后降支冠状动脉的关系。
用软尺测量左纤维环与CCA和室间后动脉的距离。在50例中的19例中，冠状动脉与瓣环的距离在23个不同点为3毫米，在8个不同点为2毫米，在2个不同点为1毫米。
在二尖瓣手术中，尤其是在左冠状动脉优势或共优势且CCA在房室沟中非常靠近二尖瓣环走行的患者中，可能会发生CCA损伤。因此，本研究强调术前了解冠状动脉解剖结构的重要性。
