Chokron R, Pornin M, Allal J, Bouziri S, Lecompte Y, Morin D, Bouniol B, Ourbak P, Maurice P
Arch Mal Coeur Vaiss. 1986 Aug;79(9):1376-9.
The authors report the case of an asymptomatic 45 year old man in whom an abnormal origin of the left coronary artery was discovered fortuitously. Coronary angiography was carried out for electrocardiographic signs of anterior myocardial infarction and showed the left coronary artery arising from the pulmonary artery: there was apical dyskinesia with alteration of global left ventricular function. The ostium of the left coronary artery was closed and a saphenous vein aorto-left anterior descending artery bypass was performed. There were no complications. Left ventricular function has not improved 8 months after surgery. The haemodynamic and coronary signs of myocardial ischaemia demonstrated preoperatively regressed after surgery: the coronary "steal" caused by the malformation which led to poor perfusion of the territory of the left coronary artery has therefore been corrected by surgery. This procedure should be carried out as early as possible in order to limit extension of the myocardial lesions.
作者报告了一例45岁无症状男性病例，其左冠状动脉异常起源是偶然发现的。因前壁心肌梗死的心电图征象进行了冠状动脉造影，结果显示左冠状动脉起源于肺动脉：存在心尖运动障碍，左心室整体功能改变。左冠状动脉开口被封闭，并进行了大隐静脉主动脉-左前降支动脉搭桥术。无并发症发生。术后8个月左心室功能未改善。术前显示的心肌缺血的血流动力学和冠状动脉征象术后消退：因此，由畸形导致的左冠状动脉供血区域灌注不良所引起的冠状动脉“窃血”已通过手术得到纠正。为限制心肌病变的扩展，该手术应尽早进行。
