Tuzcu E M, Moodie D S, Chambers J L, Keyser P, Hobbs R E
Department of Cardiology, Cleveland Clinic Foundation, Ohio 44195.
Cleve Clin J Med. 1990 Mar-Apr;57(2):147-52. doi: 10.3949/ccjm.57.2.147.
Coronary artery anomalies are commonly associated with congenital heart disease. It is important to recognize these anomalies to avoid errors in diagnosis, decrease technical difficulties in angiography, and prevent inadvertent injury in surgery. We found that of 66,884 patients who underwent coronary arteriography between 1972 and 1982 at the Cleveland Clinic Foundation, 1,000 had coronary anomalies. Of these, 101 had associated congenital anomalies: 29 had mitral valve prolapse, 18 had bicuspid aortic valves, 16 had tetralogy of Fallot, 11 had corrected transposition, 10 had a univentricular heart, 6 had coarctation of the aorta, 3 had ventricular septal defects, and 8 had miscellaneous congenital heart defects. The most common coronary anomaly was ectopic origin of a coronary artery: 30 from the sinus of Valsalva, 12 from the ascending aorta, 11 from the pulmonary artery. Nineteen patients had no left main trunk. Thirteen patients had coronary artery fistulas and 21 had miscellaneous coronary anomalies.
冠状动脉异常通常与先天性心脏病相关。认识这些异常对于避免诊断错误、减少血管造影的技术难度以及防止手术中的意外损伤很重要。我们发现，在1972年至1982年间于克利夫兰诊所基金会接受冠状动脉造影的66884例患者中，有1000例存在冠状动脉异常。其中，101例伴有先天性异常：29例有二尖瓣脱垂，18例有二叶式主动脉瓣，16例有法洛四联症，11例有矫正型大动脉转位，10例有单心室心脏，6例有主动脉缩窄，3例有室间隔缺损，8例有其他先天性心脏缺陷。最常见的冠状动脉异常是冠状动脉异位起源：30例起源于瓦氏窦，12例起源于升主动脉，11例起源于肺动脉。19例没有左主干。13例有冠状动脉瘘，21例有其他冠状动脉异常。
