Sivri N, Aktoz M, Yalta K, Ozcelik F, Altun A
Cardiology Department, Trakya University, Edirne, Turkey.
Hippokratia. 2012 Jul;16(3):246-9.
Congenital anomalies of the coronary arteries are rarely encountered in patients undergoing cardiac catheterization. In patients undergoing coronary angioplasty or cardiac surgery, angiographic recognition of coronary anomalies is important for the proper management of these patients.
We retrospectively reviewed the records of 12,844 patients who had previously undergone coronary angiography in the catheterization laboratory of Trakya University Cardiology Department over the past 14 years. We tried to investigate the presence of a variety of coronary anomalies in these patients to determine the prevalence of various types of anomalies and their anatomic variation in a selected population of the European part of Turkey. The potential association between coronary atherosclerosis and congenital coronary anomalies was also investigated.
Among these patients, 95 patients were found to have major coronary anomalies that predominantly comprised anomalous aortic origin of coronary arteries. Among the major anomalies, anomalous aortic origin of the left circumflex (LCX) artery from the right sinus of Valsalva or right coronary artery (RCA) was found to be the the most prevalent (46 out of 95 patients) outnumbering the second most common anomaly that was anomalous aortic origin of the RCA (32 out of 95 patients). In the present study, the incidence of major coronary arterial anomaly was found to be 0.74 %. However, only about one third of the patients (31 out of 95, 32.6%) with major anomaly had significant coronary atherosclerotic lesions among whom nine were found to involve the LCX artery with a posterior course.
The incidence of congenital coronary anomalies in a selected population of the European part of Turkey is similar to those of other populations. Congenital coronary anomalies generally present as isolated anomalies and are not associated with an increased risk of coronary atherosclerosis in this series. Cardiologists and surgeons should be familiar with these entities for the proper management of patients undergoing cardiac surgery or coronary angioplasty.
先天性冠状动脉异常在接受心导管检查的患者中很少见。在接受冠状动脉血管成形术或心脏手术的患者中，冠状动脉异常的血管造影识别对于这些患者的正确管理很重要。
我们回顾性分析了过去14年在特拉凯大学心脏病学系导管实验室接受冠状动脉造影的12844例患者的记录。我们试图调查这些患者中各种冠状动脉异常的存在情况，以确定在土耳其欧洲部分选定人群中各种类型异常的患病率及其解剖变异。还研究了冠状动脉粥样硬化与先天性冠状动脉异常之间的潜在关联。
在这些患者中，发现95例有主要冠状动脉异常，主要包括冠状动脉的异常主动脉起源。在主要异常中，左旋支（LCX）动脉从主动脉窦右窦或右冠状动脉（RCA）的异常主动脉起源是最常见的（95例患者中有46例），超过了第二常见的异常，即RCA的异常主动脉起源（95例患者中有32例）。在本研究中，主要冠状动脉异常的发生率为0.74%。然而，只有约三分之一的主要异常患者（95例中的31例，32.6%）有明显的冠状动脉粥样硬化病变，其中9例发现LCX动脉走行于后方。
在土耳其欧洲部分选定人群中先天性冠状动脉异常的发生率与其他人群相似。先天性冠状动脉异常通常表现为孤立异常，在本系列中与冠状动脉粥样硬化风险增加无关。心脏病学家和外科医生应熟悉这些情况，以便对接受心脏手术或冠状动脉血管成形术的患者进行正确管理。
