Barrios Alonso V, Carrillo Kabana J, Marín Huerta E, Pey Illera J, Mainar V, Aguilera Saldaña M, Jiménez Mena M, Rayo Llerena I
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Rev Esp Cardiol. 1990 May;43(5):341-4.
We present the case of a patient with a dilated cardiomyopathy in which an anomaly in the origin of the left coronary artery, that arose from the right sinus of Valsalva through an own ostium and followed a retro aortic course, was recognized as an angiographic finding. The possible pathways the anomalous artery may follow, and their different clinical significances are reviewed. The angiographic sign of the aortic root, described for the identification of the anomalous origin of circumflex artery, is reviewed and its utility in the case of anomalous left coronary artery is demonstrated. In our case, Thallium-201 didn't show myocardial ischemia with the exercise and that justified, beside the doubtful efficacy of surgery as prophylaxis of sudden death when the anomalous course is retro-aortic, to maintain a conservative attitude.
我们报告了一例扩张型心肌病患者，其血管造影发现左冠状动脉起源异常，该冠状动脉从主动脉窦右窦通过自身开口发出，并走行于主动脉后方。本文回顾了异常动脉可能走行的路径及其不同的临床意义。还回顾了用于识别回旋支动脉异常起源的主动脉根部血管造影征象，并展示了其在异常左冠状动脉病例中的应用。在我们的病例中，铊-201运动试验未显示心肌缺血，这证明，除了异常走行于主动脉后方时手术预防猝死的疗效存疑外，采取保守态度是合理的。
