Hirayama Ryo, Suzuki Ryusuke, Watanabe Toshiaki, Matsukawa Mai, Sakaguchi Takeshi, Uekihara Kenta, Yoshioka Yuki, Mouri Masaharu, Miyamoto Tomoya, Nakajima Masamichi
Department of Cardiovascular Surgery, Japanese Red Cross Kumamoto Hospital, Kumamoto, Japan.
Kyobu Geka. 2017 May;70(5):342-347.
Anomalous aortic origin of coronary arteries is rare. We report 3 cases of surgical treatment for anomalous aortic origin of coronary arteries. Case 1 was a 38-year-old man who was saved by the use of an automated external defibrillator from cardiopulmonary arrest while exercising. The coronary angiogram showed the right coronary artery arising from the left coronary sinus of Valsalva and being located between the aorta and the pulmonary trunk. He underwent coronary artery bypass grafting (CABG) using the right internal thoracic artery with ligation of proximal part of right coronary artery to prevent sudden death. Case 2 was a 76-year-old woman with the left coronary artery arising from the right coronary sinus of Valsalva and proximal left anterior descending coronary artery stenosis. She underwent CABG. Case 3 was a 58-year-old man with severe aortic valve regurgitation. He underwent aortic valve replacement. During weaning from cardiopulmonary bypass, the electrocardiogram revealed ST-segment elevation. Transesophageal echocardiography showed intramural segment of the left coronary artery and obstruction of the left coronary blood flow. Repair was accomplished by unroofing the intramural segment. All the cases were successfully treated by surgical treatment.
冠状动脉异常起源于主动脉较为罕见。我们报告3例冠状动脉异常起源于主动脉的手术治疗病例。病例1是一名38岁男性，在运动时因心脏骤停使用自动体外除颤器获救。冠状动脉造影显示右冠状动脉起源于瓦尔萨尔瓦左冠状窦，位于主动脉和肺动脉干之间。他接受了冠状动脉旁路移植术（CABG），使用右胸廓内动脉并结扎右冠状动脉近端以预防猝死。病例2是一名76岁女性，左冠状动脉起源于瓦尔萨尔瓦右冠状窦且左冠状动脉前降支近端狭窄。她接受了CABG。病例3是一名58岁男性，患有严重主动脉瓣反流。他接受了主动脉瓣置换术。在体外循环脱机过程中，心电图显示ST段抬高。经食管超声心动图显示左冠状动脉壁内段及左冠状动脉血流梗阻。通过打开壁内段进行修复。所有病例均通过手术治疗成功治愈。
