右冠状动脉异常起源：右胸廓内动脉至右冠状动脉旁路移植术并非解决之道。
Anomalous origin of the right coronary artery: right internal thoracic artery to right coronary artery bypass is not the answer.
作者信息
Fedoruk Lynn M, Kern John A, Peeler Benjamin B, Kron Irving L
机构信息
University of Virginia, Division of Thoracic and Cardiovascular Surgery, Charlottesville, Va, USA.
出版信息
J Thorac Cardiovasc Surg. 2007 Feb;133(2):456-60. doi: 10.1016/j.jtcvs.2006.10.011.
OBJECTIVE
Anomalous origin of the right coronary artery from the opposite sinus of Valsalva can be a lethal congenital anomaly. Right internal thoracic artery grafting to the right coronary artery is prone to fail in this circumstance. We sought to describe alternative surgical techniques.
METHODS
Retrospective analysis identified 5 adult and pediatric patients in our database. We reviewed the surgical techniques used to repair this anomaly. On the basis of our experience, we describe our management technique.
RESULTS
There were no operative deaths, and postoperative computed tomographic scans demonstrated widely patent repairs in all patients. Two patients with previous right internal thoracic artery to right coronary artery grafts presented with occlusion of the right internal thoracic artery. Short-term follow-up demonstrated continued patency.
CONCLUSION
Right internal thoracic artery grafting fails in this circumstance, and alternative surgical options provide a good outcome.
目的
右冠状动脉起源于对侧瓦尔萨尔瓦窦是一种可能致命的先天性异常。在这种情况下，将右胸廓内动脉移植到右冠状动脉容易失败。我们试图描述其他手术技术。
方法
回顾性分析在我们数据库中识别出的5例成年和儿科患者。我们回顾了用于修复这种异常的手术技术。根据我们的经验，我们描述了我们的处理技术。
结果
无手术死亡病例，术后计算机断层扫描显示所有患者的修复处均广泛通畅。2例曾接受右胸廓内动脉至右冠状动脉移植的患者出现右胸廓内动脉闭塞。短期随访显示仍保持通畅。
结论
在这种情况下，右胸廓内动脉移植会失败，而其他手术选择可带来良好的结果。
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