Vigneron M, Ninet J, Bernard Y, Nony P, Beaune J, Champsaur G
Service de chirurgie cardiovasculaire C, hôpital Cardiologique, Lyon.
Arch Mal Coeur Vaiss. 1991 Jan;84(1):113-6.
The authors report two cases of anomalous origin of the left coronary artery from the pulmonary artery in the adult. The two patients were pauci-symptomatic and were successfully operated, the one by reimplantation of the left coronary artery in the aorta and the other by an internal mammary artery left anterior descending artery bypass. Resting and stress myocardial scintigraphy and radionuclide ventriculography were performed before and after surgery in both cases. An analysis of segmental wall motion was possible in one patient. Before surgery, there was hypo-fixation of the tracer during the stress test and an alteration of left ventricular function. Postoperative isotopic investigations confirmed the efficacy of surgery the absence of regional ischemia and the normalisation of the ventricular contraction. These results argue in favour of a surgical reconstruction of a two coronary system, given the spontaneous risk of sudden death in this condition.
作者报告了两例成人左冠状动脉起源于肺动脉的病例。这两名患者症状轻微，均成功接受了手术，一例是将左冠状动脉重新植入主动脉，另一例是通过乳内动脉左前降支搭桥术。两例患者在手术前后均进行了静息和负荷心肌闪烁扫描及放射性核素心室造影。其中一名患者能够进行节段性室壁运动分析。手术前，负荷试验期间示踪剂摄取减低，左心室功能改变。术后同位素检查证实了手术的有效性、无局部缺血以及心室收缩正常化。鉴于这种情况下存在猝死的自发风险，这些结果支持对双冠状动脉系统进行手术重建。
