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Providing insights into atherosclerosis: A case of multivessel coronary artery disease with an anomalous straightforward vessel spared from atherosclerosis.深入了解动脉粥样硬化：一例多支冠状动脉疾病合并一支未患动脉粥样硬化的异常直血管病例。
Int J Angiol. 2010 Summer;19(2):e91-3. doi: 10.1055/s-0031-1278370.
2
Left ventricular dysfunction: Neither a matter of atherosclerosis nor an anomalous originated right coronary artery from left anterior descending artery.左心室功能障碍：既不是动脉粥样硬化问题，也不是右冠状动脉起源于左前降支的异常情况。
ARYA Atheroscler. 2015 Jul;11(4):252-5.
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Morbidity associated with anomalous origin of the right coronary artery from the left sinus of Valsalva.与右冠状动脉起源于左冠状动脉窦异常相关的发病率。
Am Heart J. 1980 Jan;99(1):96-100. doi: 10.1016/0002-8703(80)90319-1.
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Anomalous origin of the left anterior descending coronary artery from the right sinus of Valsalva associated with effort angina pectoris.左前降支冠状动脉起源于瓦尔萨尔瓦窦右侧并伴有劳力性心绞痛。
Eur Heart J. 1993 Jan;14(1):129-31. doi: 10.1093/eurheartj/14.1.129.
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A rare coronary anomaly consisting of a single right coronary ostium in an adult undergoing surgical coronary revascularization: a case report and review of the literature.一名接受外科冠状动脉血运重建术的成年患者出现罕见的冠状动脉异常，表现为单一右冠状动脉开口：病例报告及文献复习
J Med Case Rep. 2016 Jul 1;10(1):190. doi: 10.1186/s13256-016-0977-5.
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[Comparative analysis of atherosclerotic plaque distribution in the left main coronary artery and proximal segments of left anterior descending and left circumflex arteries in patients qualified for percutaneous coronary angioplasty].[适合经皮冠状动脉介入治疗患者左冠状动脉主干及左前降支和左旋支近端节段动脉粥样硬化斑块分布的比较分析]
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Myocardial ischemia caused by a coronary anomaly left anterior descending coronary artery arising from right sinus of Valsalva.由冠状动脉异常引起的心肌缺血，左前降支冠状动脉起源于瓦尔萨尔瓦右窦。
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Anomalous origin of the left main coronary artery from the right sinus of Valsalva.左冠状动脉起源于瓦尔萨尔瓦右窦异常。
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Anomalous origin of left anterior descending and circumflex coronary artery from two separate ostia in the right sinus of valsalva with unusual dominant right coronary artery.左前降支和回旋支冠状动脉分别起源于主动脉窦右窦的两个不同开口，同时右冠状动脉呈异常优势。
J Invasive Cardiol. 2010 Nov;22(11):E180-2.
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Anomaly of the left anterior descending coronary artery arising from the right sinus of valsalva and ventricular septal defect in adult: a rare case.成人中左前降支冠状动脉起源于右冠窦且合并室间隔缺损的异常情况：1例罕见病例。
Yonsei Med J. 2005 Oct 31;46(5):729-32. doi: 10.3349/ymj.2005.46.5.729.

引用本文的文献

1
Clinical presentation and outcomes in type IV dual left anterior descending artery anomaly.IV型双左前降支动脉异常的临床表现及预后
Interv Med Appl Sci. 2016 Mar;8(1):32-36. doi: 10.1556/1646.8.2016.1.7.

本文引用的文献

1
Primary congenital anomalies of the coronary arteries and relation to atherosclerosis: an angiographic study in Lebanon.冠状动脉原发性先天性异常及其与动脉粥样硬化的关系：黎巴嫩的一项血管造影研究
J Cardiothorac Surg. 2009 Oct 29;4:58. doi: 10.1186/1749-8090-4-58.
2
The subendothelial extracellular matrix modulates JNK activation by flow.内皮下细胞外基质通过血流调节JNK激活。
Circ Res. 2009 Apr 24;104(8):995-1003. doi: 10.1161/CIRCRESAHA.108.186486. Epub 2009 Mar 12.
3
Anomalous origin of the left coronary artery from the right coronary artery: a rare case of a single coronary artery originating from the right sinus of Valsalva in a man with suspected coronary artery disease.左冠状动脉起源于右冠状动脉：一名疑似冠心病男性患者罕见的单支冠状动脉起源于瓦尔萨尔瓦窦右侧的病例
J Invasive Cardiol. 2005 Jan;17(1):56-8.
4
Coronary artery anomalies. Part I: Recent insights from molecular embryology.冠状动脉异常。第一部分：分子胚胎学的最新见解。
Z Kardiol. 2004 Dec;93(12):929-37. doi: 10.1007/s00392-004-0152-7.
5
Double left anterior descending artery originating from the left and right coronary artery: a rare coronary artery anomaly.双支左前降支分别起源于左、右冠状动脉：一种罕见的冠状动脉异常。
Cathet Cardiovasc Diagn. 1993 Sep;30(1):45-7. doi: 10.1002/ccd.1810300112.
6
Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications.双左前降支冠状动脉：重要变异的血管造影描述及手术意义
Am Heart J. 1983 Mar;105(3):445-55. doi: 10.1016/0002-8703(83)90363-0.

深入了解动脉粥样硬化：一例多支冠状动脉疾病合并一支未患动脉粥样硬化的异常直血管病例。

Providing insights into atherosclerosis: A case of multivessel coronary artery disease with an anomalous straightforward vessel spared from atherosclerosis.

作者信息

Canga Yiğit, Güvenç Tolga Sinan, Ilhan Erkan, Satılmış Seçkin, Altay Servet, Karataş Mehmet Baran, Durmuş Gündüz, Hasdemir Hakan

机构信息

Department of Cardiology, Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.

出版信息

Int J Angiol. 2010 Summer;19(2):e91-3. doi: 10.1055/s-0031-1278370.

DOI:10.1055/s-0031-1278370
PMID:22477597
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3005408/
Abstract

Atherosclerotic plaques tend to involve arterial localizations in which blood flow is not laminar due to arterial bends and bifurcations. A 49-year-old man was admitted to hospital with breathlessness and was subsequently diagnosed with left ventricular failure. Coronary angiography revealed three-vessel coronary artery disease and an anomalous extra left anterior descending artery taking off from the right sinus of Valsalva and spared from atherosclerosis. The absence of side branches and the relative lack of bends in arterial geometry were considered to be the cause of resistance to atherosclerosis. The present case identifies local flow conditions as an important factor determining the genesis of atherosclerosis in arterial segments.

摘要

动脉粥样硬化斑块往往累及动脉局部，在这些部位，由于动脉弯曲和分支，血流并非层流。一名49岁男性因呼吸困难入院，随后被诊断为左心室衰竭。冠状动脉造影显示三支血管冠状动脉疾病以及一条异常的额外左前降支动脉，该动脉从瓦尔萨尔瓦窦右侧发出，未发生动脉粥样硬化。侧支血管的缺失以及动脉几何形状中相对较少的弯曲被认为是抵抗动脉粥样硬化的原因。本病例表明局部血流状况是决定动脉节段动脉粥样硬化发生的一个重要因素。