Wang Shih-Pu, Jao Yeun Tarl Fresner Ng, Han Shu-Chen
Int J Cardiol. 2008 Jan 24;123(3):e59-61. doi: 10.1016/j.ijcard.2006.11.154. Epub 2007 Mar 6.
High aortocoronary junction of the right coronary artery (RCA) above the sinus of Valsalva is not rare. There is controversy whether it is a benign finding or a life threatening condition. A 47-year-old male, who had recurrent acute coronary syndrome underwent coronary arteriogram twice showing only an aberrant origin of the RCA ostium from the left coronary cuspid. Sixty-four cut multislice computed tomogram (MSCT) of the coronary arteries showed the RCA ostium taking off above the right sinus of Valsalva. The RCA then shifted leftward and coursed between the great vessels. Compression of its proximal segment as it passed between the aorta and pulmonary artery explained the recurrent coronary attack. High take-off of the RCA ostium above its cuspid should be considered a risk factor for acute coronary attack under certain conditions. MSCT is valuable in providing better spatial images compared to the more invasive conventional coronary arteriography.
右冠状动脉（RCA）在主动脉窦上方的高位主动脉冠状动脉连接并不罕见。它是良性发现还是危及生命的情况存在争议。一名47岁男性反复出现急性冠状动脉综合征，两次进行冠状动脉造影仅显示RCA开口异常起源于左冠状动脉瓣叶。冠状动脉的64层多层螺旋计算机断层扫描（MSCT）显示RCA开口在右主动脉窦上方发出。然后RCA向左移位并在大血管之间走行。其近端段在主动脉和肺动脉之间通过时受到压迫解释了冠状动脉反复发作的原因。在某些情况下，RCA开口在其瓣叶上方的高位发出应被视为急性冠状动脉发作的危险因素。与侵入性更强的传统冠状动脉造影相比，MSCT在提供更好的空间图像方面具有价值。
