Karabay Kanber Ocal, Uysal Ender, Bağırtan Bayram, Vural Mutlu
Department of Cardiology, Jfk Hospital, İstanbul, Turkey.
Turk Kardiyol Dern Ars. 2010 Oct;38(7):496-8.
A circumflex (Cx) artery originating from the right coronary artery is one of the most common congenital coronary anomalies and is usually thought to be benign. Twin Cx arteries represent a very rare congenital anomaly with only three reported cases. Herein, we present a case of twin Cx arteries originating from the left main and right coronary arteries, respectively. A 50-year old male patient was admitted with chest pain. The electrocardiogram showed ST-segment elevation in leads D2, D3, and AVF, and ST-segment depression in the anterior leads. With the diagnosis of acute inferior myocardial infarction, the patient underwent coronary angiography which showed that the left Cx originating from the left main coronary artery was totally occluded by a thrombus in the mid-portion. There was another Cx arising from the proximal part of the right coronary artery with a significant stenosis in the proximal segment. Balloon angioplasty and stenting were successfully performed for the left Cx lesion, followed by direct stenting of the right Cx lesion one month later. The two Cx arteries were also evaluated by cardiac computed tomography angiography. The right Cx coursed between the pulmonary artery and the aorta and supplied the right part of the lateral wall of the left ventricle. The left Cx was located in the lateral wall and supplied the left part of the lateral wall of the left ventricle.
起源于右冠状动脉的回旋支（Cx）动脉是最常见的先天性冠状动脉异常之一，通常被认为是良性的。双支回旋支动脉是一种非常罕见的先天性异常，仅有三例报道。在此，我们报告一例分别起源于左主干和右冠状动脉的双支回旋支动脉病例。一名50岁男性患者因胸痛入院。心电图显示D2、D3和AVF导联ST段抬高，前壁导联ST段压低。诊断为急性下壁心肌梗死，患者接受冠状动脉造影，结果显示起源于左主干冠状动脉的左回旋支在中段被血栓完全阻塞。另有一支回旋支起源于右冠状动脉近端，近端节段有明显狭窄。对左回旋支病变成功进行了球囊血管成形术和支架置入术，一个月后对右回旋支病变进行了直接支架置入术。还通过心脏计算机断层扫描血管造影对两支回旋支动脉进行了评估。右回旋支走行于肺动脉和主动脉之间，供应左心室侧壁右侧部分。左回旋支位于侧壁，供应左心室侧壁左侧部分。
