Atik E, Marcial M B, Ikari N M, Kajita L, Machado D, Ebaid M, Jatene A
Instituto do Coração do Hospital das Clinicas USP, São Paulo.
Arq Bras Cardiol. 1991 Aug;57(2):121-7.
Three infants with anomalous origin of left coronary artery, being two from the right pulmonary artery and one from the left, without other congenital defects, ages of 5, 15 and 3 months old, presented with early congestive heart failure due to anterolateral myocardial infarction. Anatomical characteristic was peculiar in two cases since the left coronary artery, before the anastomosis with the right pulmonary artery, presented a wy, 15 mm extension path within the aortic wall which has facilitated the surgical correction by the proximity of these structures. In the third case, the left coronary artery was anastomosed with the left pulmonary artery, 2 cm from its origin and anterior to the left atrium being the surgical correction by direct implant at the ascending aorta. Post-operative follow-up, 36, 30 and 33 months respectively, showed clinical and laboratorial normalization except for the second case in which ST segment remained upward due to ventricular aneurysm. Myocardial recovery, even after extensive infarction, in this anomaly, emphasizes the need for earlier diagnosis and management.
三名左冠状动脉异常起源的婴儿，其中两名起源于右肺动脉，一名起源于左肺动脉，无其他先天性缺陷，年龄分别为5个月、15个月和3个月，因前外侧心肌梗死出现早期充血性心力衰竭。两例的解剖特征较为特殊，因为左冠状动脉在与右肺动脉吻合之前，在主动脉壁内有一条15毫米的“W”形延伸路径，这使得这些结构靠近，便于进行手术矫正。在第三例中，左冠状动脉在距其起源2厘米处与左肺动脉吻合，位于左心房前方，通过直接植入升主动脉进行手术矫正。术后随访时间分别为36个月、30个月和33个月，除第二例因室壁瘤ST段仍向上外，其余临床和实验室检查均恢复正常。即使在广泛梗死之后，这种异常情况下心肌仍能恢复，这强调了早期诊断和治疗的必要性。
