Unzué Leire, García Eulogio, López-Melgar Beatriz, Agudo-Quilez Pilar
Interventional Cardiology, Hospital Universitario Madrid Montepríncipe, Madrid, Spain.
Interventional Cardiology, Hospital Universitario Madrid Montepríncipe, Madrid, Spain.
Cardiovasc Revasc Med. 2018 Jul-Aug;19(5 Pt B):632-637. doi: 10.1016/j.carrev.2018.01.008. Epub 2018 Feb 7.
Anomalous origin of a coronary artery from the opposite sinus of Valsalva (ACAOS) is a rare malformation traditionally considered "malignant" in cases of interarterial course. Recently, a protective effect of the low interarterial subtype (between the aorta and the right ventricle outflow tract) has been described. We present an IVUS-guided percutaneous intervention in a patient with anomalous origin of the left coronary artery from the right coronary sinus presenting with anterior ischemia. In patients with ACAOS, the integration of complementary image techniques is recommended, defining the anomalous course of the vessel and providing an accurate assessment of the individual risk for each patient. The use of IVUS may be advisable, emerging as a really useful tool to complete the study and guide the treatment.
冠状动脉起源于对侧瓦尔萨尔瓦窦（ACAOS）是一种罕见的畸形，传统上在动脉间走行的情况下被认为是“恶性的”。最近，已经描述了低动脉间亚型（在主动脉和右心室流出道之间）的保护作用。我们报告了一例经血管内超声（IVUS）引导的经皮介入治疗，该患者左冠状动脉起源于右冠状动脉窦并伴有前壁心肌缺血。对于ACAOS患者，建议综合运用多种影像技术，明确血管的异常走行，并准确评估每个患者的个体风险。使用IVUS可能是可取的，它已成为完善研究和指导治疗的一项非常有用的工具。
