Daralammouri Yunis, Ghannam Malik, Lauer Bernward
Department of Cardiology, Al Najah National University Hospital, Nablus, West Bank, Palestine.
Department of Cardiology, Zentralklinik Bad Berka, Robert-Koch-Allee 9, 99437, Bad Berka, Germany.
J Med Case Rep. 2016 Aug 2;10:211. doi: 10.1186/s13256-016-1003-7.
A normal anatomy of coronary arteries is important to have adequate cardiac muscle blood supply especially during extraneous physical activities. This case report describes a rare coronary anomaly in which the accessory coronary artery arose from the right coronary artery, reentered the left anterior descending coronary artery, and then ran as a single vessel.
We present a case of a coronary anomaly in a 47-year-old white man who presented with atypical angina. Computed tomographic angiography and coronary angiography showed a variant of dual left anterior descending coronary artery not previously described. Our patient's accessory coronary artery arose from his right coronary artery. It took an intramuscular course beneath the right ventricular outflow tract in the interventricular septal area to the anterior interventricular sulcus, giving off septal perforators that reentered his medial left anterior descending coronary artery. Both vessels ran after the anastomosis in the anterior interventricular sulcus as a single vessel.
We propose that this anomaly represents a new variant of coronary artery anomaly. This coronary artery anomaly does not cause ischemia. Recognition of this coronary anomaly is important in patients undergoing percutaneous coronary intervention or coronary artery bypass graft operations.
冠状动脉正常解剖结构对于确保充足的心肌血液供应至关重要，尤其是在进行额外的体力活动期间。本病例报告描述了一种罕见的冠状动脉异常情况，其中副冠状动脉起源于右冠状动脉，重新进入左前降支冠状动脉，然后作为单一血管走行。
我们报告一例47岁白人男性冠状动脉异常病例，该患者表现为非典型心绞痛。计算机断层扫描血管造影和冠状动脉造影显示了一种此前未描述过的双左前降支冠状动脉变异。我们患者的副冠状动脉起源于右冠状动脉。它在室间隔区域的右心室流出道下方走行于肌层内，至前室间沟，发出间隔穿支，重新进入其左前降支冠状动脉内侧。吻合后，两支血管在前室间沟作为单一血管走行。
我们认为这种异常代表了一种新的冠状动脉异常变异。这种冠状动脉异常不会导致缺血。认识到这种冠状动脉异常对于接受经皮冠状动脉介入治疗或冠状动脉旁路移植手术的患者很重要。
