Kumagai Kazuya, Kin Hajime, Ikai Akio, Okabayashi Hitoshi
Department of Cardiovascular Surgery, Iwate Medical University, Memorial Heart Center, Iwate, Japan.
Interact Cardiovasc Thorac Surg. 2014 May;18(5):695-7. doi: 10.1093/icvts/ivu018. Epub 2014 Feb 12.
Anomalous origin of the left coronary artery (LCA) from the right sinus of Valsalva is rare and is known to cause sudden death in young patients. A 17-year old male patient experienced syncopal episodes after intense exercise. No abnormal findings were noted on brain magnetic resonance imaging, electroencephalography or Holter monitoring. Contrast-enhanced coronary computed tomography revealed the anomalous origin of the LCA from the right sinus of Valsalva. Considering the positional relationship with the aortic valve and the morphology of the left main trunk, a neo-ostium was created in the left coronary sinus, and patch angioplasty was performed using pulmonary arterial wall tissue. The postoperative course of the patient was uneventful, and the patient remains asymptomatic 2 years after surgery. Here, we describe this case and review the literature on the different surgical techniques for this anomaly. We believe that our technique would be useful in cases of anomalous origin of the LCA from the right sinus of Valsalva, regardless of morphological variations.
左冠状动脉（LCA）起源于瓦尔萨尔瓦右窦异常罕见，已知可导致年轻患者猝死。一名17岁男性患者在剧烈运动后出现晕厥发作。脑磁共振成像、脑电图或动态心电图监测均未发现异常。冠状动脉增强计算机断层扫描显示LCA起源于瓦尔萨尔瓦右窦异常。考虑到与主动脉瓣的位置关系及左主干形态，在左冠状窦创建了一个新开口，并使用肺动脉壁组织进行了补片血管成形术。患者术后病程平稳，术后2年仍无症状。在此，我们描述该病例并回顾有关该异常不同手术技术的文献。我们认为，无论形态学变异如何，我们的技术在LCA起源于瓦尔萨尔瓦右窦异常的病例中均有用。
