Imori Yoichi, Murakami Masato, Tanaka Masashi, Saito Shigeru
Department of Cardiovascular Medicine, Shonan Kamakura General Hospital, Kanagawa, Japan.
BMJ Case Rep. 2014 Oct 23;2014:bcr2014206351. doi: 10.1136/bcr-2014-206351.
A 45-year-old man previously diagnosed with myxomatous mitral valve disease was admitted to our hospital with chest pain at rest and on effort. Contrast-enhanced CT revealed that the patient's right coronary artery originated from the left sinus Valsalva, which was compressed between the aortic and pulmonary roots. This anatomical abnormality can be associated with sudden death, syncope and chest pain. Ultrasonography showed mitral valve prolapse with severe regurgitation. Surgical repair was performed, which included coronary artery bypass graft and mitral valvoplasty with tricuspid annuloplasty. The postoperative course was uneventful and the patient remains asymptomatic. This is the first description of the coexistence of an anomalous origin of the right coronary artery with myxomatous mitral valve disease.
一名先前被诊断患有黏液瘤样二尖瓣疾病的45岁男性因静息和活动时胸痛入院。增强CT显示,患者右冠状动脉起源于左冠窦,在主动脉和肺动脉根部之间受压。这种解剖异常可能与猝死、晕厥和胸痛有关。超声心动图显示二尖瓣脱垂伴严重反流。进行了手术修复,包括冠状动脉搭桥术和二尖瓣成形术及三尖瓣环成形术。术后过程顺利,患者仍无症状。这是首次描述右冠状动脉异常起源与黏液瘤样二尖瓣疾病并存的情况。