Sievers H H, Lange P E, Heintzen P H, Bernhard A
Thorac Cardiovasc Surg. 1985 Jun;33(3):198-9.
Early branching of the left coronary artery (LCA) may become an additional operative challenge during coronary transfer in anatomic correction of transposition of the great arteries. An early branch of the LCA running in opposite transfer direction was present in 3 out of 25 patients who underwent anatomic correction. By excising a large cuff of aortic sinus wall around the ostium of the LCA enough length was gained for successful coronary transfer without kinking in 2 patients in whom the first branch was arising at the level of the origin of the circumflex artery. In the third patient with the first branch arising proximal to the origin of the circumflex artery an alternative surgical procedure seemed preferable. In such a coronary anomaly optimal visualization of the coronary branching pattern, possibly including selective coronary angiography, is advisable for better planning of the surgical technique.
在大动脉转位的解剖矫正术中进行冠状动脉移植时，左冠状动脉（LCA）的早期分支可能会成为额外的手术挑战。在接受解剖矫正的25例患者中，有3例存在LCA的早期分支，其走行与移植方向相反。对于其中2例第一分支起源于回旋支动脉起始水平的患者，通过切除LCA开口周围一大块主动脉窦壁，获得了足够的长度，从而成功进行冠状动脉移植且无扭结。对于第三例第一分支起源于回旋支动脉起始近端的患者，似乎采用另一种手术方法更为合适。对于这种冠状动脉异常情况，建议对冠状动脉分支模式进行最佳可视化，可能包括选择性冠状动脉造影，以便更好地规划手术技术。
