Anuwatworn Amornpol, Karta Pratima, Yee Jimmy, Li Shenjing, Kumar Vishesh, Steffen Kelly
University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota.
S D Med. 2018 Mar;71(3):130-132.
There are many variations of coronary anatomy encountered during coronary angiogram. Anatomy demonstrating a single coronary artery is a rare congenital coronary artery anomaly. The entire heart is supplied solely by a coronary artery with single coronary ostium. We present a rare case of single coronary artery arising from the right sinus of Valsalva. The patient had presented with atypical chest pain and a stress test was performed, which was abnormal. We proceeded with coronary angiography which showed a common ostium of the right and left coronary artery coming from the right coronary cusp. The coronary computed tomography angiography revealed the left main had a pre-pulmonic course, crossing the base of the heart and passing anterior to the pulmonary artery and then branching into the left anterior descending artery and left circumflex artery. Patients with single coronary artery usually has benign prognosis; however, a specific coronary anomaly may result in myocardial ischemia and sudden cardiac death if the anomalous coronary artery takes an intra-arterial course, running between the aorta and the pulmonary artery. Coronary computed tomography angiography is a useful imaging modality to identify anatomical course of coronary anomaly.
在冠状动脉造影过程中会遇到多种冠状动脉解剖变异情况。显示单支冠状动脉的解剖结构是一种罕见的先天性冠状动脉异常。整个心脏仅由一条具有单个冠状动脉口的冠状动脉供血。我们报告一例罕见的起源于瓦尔萨尔瓦右窦的单支冠状动脉病例。该患者表现为非典型胸痛，进行了负荷试验，结果异常。我们接着进行了冠状动脉造影，显示右冠状动脉和左冠状动脉共同开口于右冠状动脉瓣叶。冠状动脉计算机断层扫描血管造影显示左主干走行于肺门前，穿过心脏底部，在肺动脉前方通过，然后分支为左前降支动脉和左旋支动脉。单支冠状动脉患者通常预后良好；然而，如果异常冠状动脉走行于动脉内，即在主动脉和肺动脉之间走行，特定的冠状动脉异常可能导致心肌缺血和心源性猝死。冠状动脉计算机断层扫描血管造影是识别冠状动脉异常解剖走行的一种有用的成像方式。
