Department of Cardiovascular Surgery, Hyogo College of Medicine, Hyogo, Japan.
Ann Thorac Surg. 2010 Mar;89(3):961-3. doi: 10.1016/j.athoracsur.2009.07.055.
We report a case with rare anomalous origins of the right coronary artery that arises from the ascending aorta. An 82-year-old woman scheduled for aortic valve replacement for severe aortic stenosis was incidentally found to have an unusual origin of the right coronary artery during routine screening for coronary artery disease by preoperative 64-slice multi-detector row computed tomographic angiography. The artery originated from the left surface of the ascending aorta approximately 2 cm above the sinotubular junction, where the transverse aortotomy is routinely placed. This detection resulted in avoidance of an intraoperative interruption of the right coronary artery. A preoperative multi-detector row computed tomography angiographic scan was very useful not only for evaluation of the coronary artery disease, but also for detection of a rare anomalous origin of the right coronary artery.
我们报告一例右冠状动脉罕见的异常起源病例，它发自升主动脉。一位 82 岁女性因严重主动脉瓣狭窄拟行主动脉瓣置换术，术前常规行 64 层多排螺旋 CT 血管造影检查以筛查冠状动脉疾病，意外发现右冠状动脉起源异常。该动脉发自升主动脉左前方，窦管交界上方约 2cm 处，此处常规行升主动脉横切口。这一发现避免了术中阻断右冠状动脉。术前多排螺旋 CT 血管造影扫描不仅有助于评估冠状动脉疾病，还可发现罕见的右冠状动脉异常起源。
