Flessas Dimitris, Mamarelis Ioannis, Maniatis Vasilis, Souretis George, Laschos Nikolaos, Kotoulas Christophoros, Lazaridis Kyriakos
Department of Cardiology, 417 VA Hospital (NIMTS), 10-12 Monis Petraki st, Athens, Greece.
J Cardiothorac Surg. 2013 Apr 4;8:61. doi: 10.1186/1749-8090-8-61.
Coronary artery anomalies are found in 0.4% to 1.4% of patients who undergo coronary angiography. Anomalous origin of left coronary artery from the right sinus of Valsava is the rarest, with a reported prevalence of 0.02 -0.03% according to angiographic studies.
We present the rare case of a 42-year-old-man suffering from stable angina with unusual development of 3 major components of the cardiovascular system Coronary angiography revealed an anomalous origin of the left coronary artery from the ostium of the right coronary artery. Magnetic resonance angiography depicted an anomalous origin of the left common carotid artery from the innominate artery and an aneurysm of descending thoracic aorta. Coronary computed tomography angiography revealed the course of left coronary artery between aortic root and conus arteriosus at the level of the right ventricular outflow tract. In this report we attempt to highlight the rarity of this vascular anatomy.
Anomalous origins of the coronary arteries are rare, but may cause myocardial ischemia and sudden death. Thus, their reliable identification is a matter of paramount importance possibly evaluating the effects of therapeutic intervention. Newer imaging modalities improve the illumination of vascular system anatomy, shedding light to diagnostic dilemmas that come up in daily medical practice.
在接受冠状动脉造影的患者中，冠状动脉异常的发生率为0.4%至1.4%。起源于右冠窦的左冠状动脉异常最为罕见，根据血管造影研究报告，其患病率为0.02%-0.03%。
我们报告了一例罕见病例，一名42岁男性患有稳定型心绞痛，心血管系统的三个主要组成部分出现异常发育。冠状动脉造影显示左冠状动脉起源于右冠状动脉开口处。磁共振血管造影显示左颈总动脉起源于无名动脉异常，以及胸降主动脉瘤。冠状动脉计算机断层扫描血管造影显示左冠状动脉在右心室流出道水平位于主动脉根部和动脉圆锥之间的走行。在本报告中，我们试图强调这种血管解剖结构的罕见性。
冠状动脉异常起源罕见，但可能导致心肌缺血和猝死。因此，可靠识别它们对于评估治疗干预效果至关重要。更新的成像方式改善了对血管系统解剖结构的显示，为日常医疗实践中出现的诊断难题提供了线索。
