Brofferio Alessandra, Shirani Jamshid, Chapman John
Department of Cardiology, Geisinger Medical Center, Danville, Pennsylvania, USA.
Am J Cardiol. 2007 Jul 15;100(2):180-1. doi: 10.1016/j.amjcard.2007.02.078. Epub 2007 Jun 4.
Of 3,856 coronary angiographic studies performed by a single operator from December 2000 to March 2006, 24 (0.6%) had an aberrant origin of the obtuse marginal branch from the left anterior descending coronary artery (n = 20, 84%) or its diagonal branch (n = 2, 8%) or from the ramus intermedius coronary artery (n = 2, 8%) with an appearance mimicking the Greek letter pi. Patients were 40 to 69 years old (54 +/- 9), all were white, and 18 (75%) were men. Obstructive coronary artery disease was present in 13 (54%) and involved the aberrant obtuse marginal branch in 4 (17%). No specific pattern of symptoms, clinical presentation, or electrocardiographic finding could be attributed directly to this coronary anomaly. In conclusion, we have described a previously unreported coronary anomaly. Potential implications of this type coronary anomaly are (1) an angiographic appearance of a missing branch of the left circumflex coronary artery and (2) extensive anteroseptal, apical, and posterolateral ischemia due to proximal left anterior descending coronary artery obstruction.
在2000年12月至2006年3月期间由一名操作者进行的3856例冠状动脉造影研究中，24例（0.6%）出现钝缘支异常起源于左前降支冠状动脉（n = 20，84%）或其对角支（n = 2，8%）或中间支冠状动脉（n = 2，8%），其形态类似希腊字母π。患者年龄在40至69岁（54±9岁），均为白人，18例（75%）为男性。13例（54%）存在阻塞性冠状动脉疾病，其中4例（17%）累及异常钝缘支。没有特定的症状模式、临床表现或心电图表现可直接归因于这种冠状动脉异常。总之，我们描述了一种先前未报道的冠状动脉异常。这种类型冠状动脉异常的潜在影响是：（1）冠状动脉造影显示左旋支冠状动脉分支缺失；（2）由于左前降支冠状动脉近端阻塞导致广泛的前间隔、心尖和后外侧心肌缺血。
