Akcay Ahmet, Tuncer Cemal, Batyraliev Talantbek, Gokce Mustafa, Eryonucu Beyhan, Koroglu Sedat, Yilmaz Remzi
Cardiology Department, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
Circ J. 2008 Aug;72(8):1254-8. doi: 10.1253/circj.72.1254.
Isolated single coronary artery (SCA) is an extremely rare congenital coronary anomaly. Some subgroups of SCA can lead to angina pectoris, acute myocardial infarction or even sudden death in the absence of atherosclerosis. Young patients, especially, have the risk of serious clinical events, but middle-aged-to elderly patients have a variable clinical course.
The aim of this study was to present the clinical and angiographic properties, relatively long-term follow-up (54+/-14 months) and management of adult patients (mean age 57+/-12 years) with SCA. The records of 70,850 patients undergoing coronary angiography between 1999 and 2005 were reviewed. Ten patients (0.024%) were found to have SCA, originating from the left sinus of Valsalva in 3 (30%) patients and from the right sinus of Valsalva in 7 patients (70%). No atherosclerotic involvement was seen in 7 (70%) patients. One patient was also treated by stent implantation to the SCA. Other patients were followed medically. All patients have been followed uneventfully.
Medical treatment is usually adequate for middle-aged to elderly patients with SCA in the absence of ischemia and/or acute coronary syndrome.
孤立性单冠状动脉(SCA)是一种极其罕见的先天性冠状动脉异常。SCA的一些亚组在无动脉粥样硬化的情况下可导致心绞痛、急性心肌梗死甚至猝死。尤其是年轻患者有发生严重临床事件的风险,但中老年患者的临床病程各不相同。
本研究的目的是介绍成年SCA患者(平均年龄57±12岁)的临床和血管造影特征、相对长期的随访(54±14个月)及治疗情况。回顾了1999年至2005年间70850例行冠状动脉造影患者的记录。发现10例患者(0.024%)患有SCA,其中3例(30%)起源于左冠状动脉窦,7例(70%)起源于右冠状动脉窦。7例(70%)患者未见动脉粥样硬化累及。1例患者还接受了SCA支架植入治疗。其他患者接受药物随访。所有患者均随访顺利。
对于无缺血和/或急性冠状动脉综合征的中老年SCA患者,药物治疗通常足够。