Krasniqi Xhevdet, Gorani Daut, Sejdiu Basri, Citaku Hajdin
Clinic for Cardiology, University Clinical Center of Kosova, Prishtina, Republic of Kosova.
Acta Inform Med. 2016 Jun;24(3):218-9. doi: 10.5455/aim.2016.24.218-219. Epub 2016 Jun 4.
Anomalous origin of coronary arteries from opposite sinus of Valsalva is rare finding. The incidence of anomalous origination of the left coronary artery from right sinus is 0.15% and the right coronary artery from the left sinus is 0.92%. The ectopic origin of left coronary artery or right coronary artery from opposite sinus depending on pathways and considering atherosclerotic changes are manifested with different clinical significance.
We report two cases, the first case the coronary angiography showed the left coronary artery arising from the right coronary sinus, presenting with proximally and distally stenosed left anterior descending artery (LAD), associated with medial and distal stenosed right coronary artery (RCA). The second case the coronary angiography revealed the right coronary artery arising from the left coronary sinus, associated with tortuous medial and distal segments of left anterior descending artery (LAD), without atherosclerotic changes. The first case successfully underwent treatment procedures based on guidelines for revascularization.
The coronary angiography of patients with coronary ischemia determines atherosclerotic disease with possibility of the presence of coronary artery anomalies that in cases with ectopic origin from opposite sinus continues to exist as a challenge during treatment in interventional cardiology.
冠状动脉起源于对侧瓦尔萨尔瓦窦是一种罕见的发现。左冠状动脉起源于右窦的发生率为0.15%，右冠状动脉起源于左窦的发生率为0.92%。根据路径并考虑动脉粥样硬化改变，左冠状动脉或右冠状动脉从对侧窦的异位起源具有不同的临床意义。
我们报告两例病例，第一例冠状动脉造影显示左冠状动脉起源于右冠状动脉窦，表现为近端和远端狭窄的左前降支动脉（LAD），伴有中段和远端狭窄的右冠状动脉（RCA）。第二例冠状动脉造影显示右冠状动脉起源于左冠状动脉窦，伴有左前降支动脉（LAD）中段和远端迂曲，无动脉粥样硬化改变。第一例成功地根据血运重建指南进行了治疗。
冠状动脉缺血患者的冠状动脉造影可确定动脉粥样硬化疾病，并可能存在冠状动脉异常，在介入心脏病学治疗中，对于起源于对侧窦的异位情况仍然是一个挑战。
