Murata N, Ohta H, Suzuki K
Department of Cardiovascular Surgery, Ohta-Nishinouch Hospital, Koriyama, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1992 Nov;40(11):2113-9.
A case was 33 years old man who had complained chest pain during exercise. He was diagnosed anomalous origin of the left coronary artery from the pulmonary artery by coronary angiography. At operation, left main coronary artery originated from the posterior wall of the pulmonary artery. Numerous retrograde flow was seen through left coronary artery during aortic cross clamping. The left coronary ostium was closed, because sufficient extracardial anastomosis to coronary artery should be thought. The post operative course was uneventful and the patient is asymptomatic. The selective bronchial artery angiography was performed and it demonstrated collaterals between the bronchial artery and the left circumflex artery. The Thallium scintigraphy had showed ischemia of antrolateral wall of the left ventricle before operation, but postoperatively there was no ischemic redistribution.
一名33岁男性患者，有运动时胸痛的症状。通过冠状动脉造影诊断为左冠状动脉起源于肺动脉异常。手术中发现左冠状动脉主干起源于肺动脉后壁。在主动脉阻断期间，可见大量血液经左冠状动脉逆行流动。由于应考虑对冠状动脉进行充分的心外吻合，故关闭了左冠状动脉开口。术后过程顺利，患者无症状。进行了选择性支气管动脉造影，显示支气管动脉与左旋支动脉之间存在侧支循环。术前铊闪烁扫描显示左心室前侧壁缺血，但术后无缺血再分布。
