Kobayashi N, Takebayashi T, Saito S, Terashita T, Shimokawa T, Matsuda S
Division of Anatomy and Embryology, Department of Integrated Basic Medical Science, Ehime University School of Medicine, Shitsukawa, To-on City, 791-0295, Japan.
Clin Anat. 2006 May;19(4):354-7. doi: 10.1002/ca.20193.
An anomalous branch of the right coronary artery was found in a 71-year-old male cadaver with a right-sided aortic arch. The anomalous artery arose from the proximal portion of the right coronary artery and ran in a retroaortic course, before reaching the posterior wall of the heart. It was recognized as the right-sided variation of the circumflex coronary artery. The aortic arch had as branches the left common carotid, right common carotid, right subclavian, and left subclavian arteries, in that order, and the descending aorta was located in the right thorax. The left subclavian artery arose from a Kommerell's diverticulum and ran behind the esophagus, and the left-sided ligamentum arteriosum was also connected at the diverticulum. Therefore, the right aortic arch was classified as type N according to Adachi-Williams-Nakagawa and type III-B1 in accordance with Stewart-Edwards. The Kommerell's diverticulum in this case seemed to press on the posterior wall of the esophagus.
在一名71岁的右侧主动脉弓男性尸体中发现了右冠状动脉的一支异常分支。该异常动脉起源于右冠状动脉近端,走行于主动脉后方,然后到达心脏后壁。它被认为是左旋支冠状动脉的右侧变异。主动脉弓依次发出左颈总动脉、右颈总动脉、右锁骨下动脉和左锁骨下动脉,降主动脉位于右胸。左锁骨下动脉起源于Kommerell憩室,走行于食管后方,左侧动脉韧带也连接于该憩室。因此,根据Adachi-Williams-Nakagawa分类,该右侧主动脉弓为N型,按照Stewart-Edwards分类为III-B1型。本例中的Kommerell憩室似乎压迫食管后壁。