Jacobs Marshall L, Mavroudis Constantine
Center for Pediatric and Congenital Heart Diseases, Cleveland Clinic, Cleveland, Ohio 44195, United States of America.
Cardiol Young. 2010 Dec;20 Suppl 3:15-9. doi: 10.1017/S1047951110001046.
Abnormalities of the coronary arterial circulation represent a broad spectrum of anomalies. Some of these coronary arterial anomalies are of little clinical significance and are generally discovered either as incidental findings at autopsy or at the time of diagnostic coronary angiography in patients with atherosclerotic ischaemic cardiac disease. Some of these coronary arterial anomalies, however, are associated with a markedly abnormal natural history that may include significant cardiac morbidity very early in infancy, or increased risk of cardiac sudden death in childhood or adolescence. It is therefore important that we have a system for the naming and classification of these anomalies, to stratify them according to the associated risk and to develop rational approaches to evaluation and management. To apply any system of nomenclature reliably and responsibly, it is essential that each term be associated with a definition that is known and accepted by users of terminology. Such definitions are included in the specifications of both the Society of Thoracic Surgeons Congenital Heart Surgery Database and the European Association for Cardio-Thoracic Surgery Congenital Heart Surgery Database. These databases use the Diagnostic Short List of the version of the International Paediatric and Congenital Cardiac Code derived from the nomenclature of the International Congenital Heart Surgery Nomenclature and Database Project of the European Association for Cardio-Thoracic Surgery and the Society of Thoracic Surgeons. This article will provide the nomenclature and definitions used by these databases for anomalies of the coronary arteries.
冠状动脉循环异常表现为一系列广泛的异常情况。其中一些冠状动脉异常临床意义不大，通常是在尸检时偶然发现，或是在患有动脉粥样硬化性缺血性心脏病患者进行诊断性冠状动脉造影时被发现。然而，其中一些冠状动脉异常与明显异常的自然病程相关，这可能包括在婴儿期早期就出现严重的心脏疾病，或在儿童期或青少年期心脏猝死风险增加。因此，我们有必要建立一个冠状动脉异常的命名和分类系统，根据相关风险对其进行分层，并制定合理的评估和管理方法。为了可靠且负责地应用任何命名系统，每个术语都必须与术语使用者已知并接受的定义相关联，这一点至关重要。此类定义包含在胸外科医师协会先天性心脏病手术数据库和欧洲心胸外科学会先天性心脏病手术数据库的规范中。这些数据库使用的是源自欧洲心胸外科学会和胸外科医师协会国际先天性心脏病手术命名与数据库项目命名法的国际儿科和先天性心脏病编码版本的诊断简表。本文将介绍这些数据库用于冠状动脉异常的命名和定义。
