Prestipino Filippo, Lusini Mario, Spadaccio Cristiano, Chello Massimo
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy
Department of Cardiovascular Science, Cardiovascular Surgery Unit, University Campus Bio-Medico of Rome, Rome, Italy.
Interact Cardiovasc Thorac Surg. 2014 Aug;19(2):347-9. doi: 10.1093/icvts/ivu132. Epub 2014 Apr 30.
Anomalous origin of the left coronary artery originating from the opposite sinus of Valsalva is a coronary anomaly with a consistently low prevalence rate. Different patterns have been described for this type of anomaly with respect to the position and course of the coronary arteries. The interarterial type can be considered a malignant variant, as it is characterized by a left main coronary artery that is positioned between the aortic root and the pulmonary artery root, and it frequently presents with syncope or aborted sudden cardiac death. Other symptoms or clinical presentations include the presence or development of angina, acute myocardial infarction and ventricular tachycardia. We present the case of a 49-year old man who presented with a new onset of chest pain; a coronary angiogram showed an anomalous left main coronary artery arising from the right Valsalva sinus, accompanied by a long and severe stenosis. It was found that multi-scan cardiac tomography is very useful in identifying the position of the coronary arteries when coronary anomalies occur.
起源于对侧瓦尔萨尔瓦窦的左冠状动脉异常是一种患病率一直较低的冠状动脉异常。关于这种类型的异常，根据冠状动脉的位置和走行描述了不同的模式。动脉间型可被视为一种恶性变异型，其特征是左主冠状动脉位于主动脉根部和肺动脉根部之间，且经常出现晕厥或心脏骤停。其他症状或临床表现包括心绞痛、急性心肌梗死和室性心动过速的出现或发展。我们报告一例49岁男性患者，其出现新发胸痛；冠状动脉造影显示左主冠状动脉起源于右瓦尔萨尔瓦窦，并伴有长段严重狭窄。研究发现，当发生冠状动脉异常时，多排心脏断层扫描在确定冠状动脉位置方面非常有用。
