Kuo Chia-Cheng, Hsing Chung-Hsi, Cheng Bor-Chih
Division of Cardiovascular Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.
Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan; Department of Anesthesiology, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Ann Thorac Surg. 2017 Jan;103(1):e35-e37. doi: 10.1016/j.athoracsur.2016.05.053.
Anomalous origin of the right coronary artery (ARCA) from the left Valsalva sinus is a rare but known cause of sudden cardiac death. Surgical revascularization techniques include coronary artery bypass grafting, unroofing, and reimplantation. We report 4 patients who underwent robot-assisted totally endoscopic coronary artery bypass (TECAB) for ARCA as an alternative surgical option. In 3 patients, a single aortocoronary saphenous vein bypass was performed, and in 1 patient the right internal mammary artery was used. All grafts are patent as shown by computed tomographic angiography or cardiac catheterization. We claim that totally endoscopic coronary artery bypass is feasible and safe for anomalous origin of the right coronary artery.
右冠状动脉起源于左冠窦（ARCA）是一种罕见但已知的心脏性猝死原因。手术血运重建技术包括冠状动脉搭桥术、开窗术和再植入术。我们报告4例接受机器人辅助全内镜冠状动脉搭桥术（TECAB）治疗ARCA的患者，作为一种替代手术选择。3例患者进行了单根主动脉-冠状动脉大隐静脉搭桥术，1例患者使用了右乳内动脉。计算机断层血管造影或心导管检查显示所有移植血管均通畅。我们认为全内镜冠状动脉搭桥术对于右冠状动脉异常起源是可行且安全的。
