Wilson C L, Dlabal P W, Holeyfield R W, Akins C W, Knauf D G
J Thorac Cardiovasc Surg. 1977 Jun;73(6):887-93.
An adult with angina was found to have anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). Review of the literature regarding this anomaly in teen-agers and adults disclosed only 25 cases diagnosed during life. Eighteen additional cases of ALCAPA in this age group have been diagnosed post mortem. In this report, we will review the management of teen-agers and adults in whom ALCAPA was correctly diagnosed during life. We shall also describe the eighth case of successful aorta-left coronary artery grafting with the saphenous vein in this age group. This case brings the total in the literature to 44. Of those patients offered surgical therapy, 13 underwent successful ligation of the anomalous artery. Saphenous vein grafts were employed in 8. Five did not undergo ligation or saphenous vein grafting. There was one death. It would appear that saphenous vein grafting is the definitive means of surgically correcting ALCAPA, because it restores the dual coronary circulation.
一名患有心绞痛的成年人被发现左冠状动脉起源异常，发自肺动脉（ALCAPA）。回顾有关青少年和成年人中这种异常情况的文献，发现生前仅诊断出25例。该年龄组另有18例ALCAPA病例是在尸检时诊断出来的。在本报告中，我们将回顾生前被正确诊断为ALCAPA的青少年和成年人的治疗情况。我们还将描述该年龄组中第八例使用大隐静脉成功进行主动脉 - 左冠状动脉移植的病例。这使得文献中的病例总数达到44例。在那些接受手术治疗的患者中，13例成功结扎了异常动脉。8例使用了大隐静脉移植。5例未进行结扎或大隐静脉移植。有1例死亡。似乎大隐静脉移植是手术矫正ALCAPA的决定性方法，因为它恢复了双重冠状动脉循环。
