Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warsaw, Poland.
Cardiovascular Research Foundation, New York.
Am J Cardiol. 2019 Sep 15;124(6):939-946. doi: 10.1016/j.amjcard.2019.06.012. Epub 2019 Jun 25.
Single coronary artery (SCA) is a rare congenital anomaly. We assessed the prevalence and anatomic characteristics of SCA diagnosed with coronary computed tomography angiography and compared the dimensions of the proximal SCA trunk with a reference group of 199 subjects with normal coronary arteries. We screened 30,230 patients who underwent coronary computed tomography angiography from 2008 to 2018 to identify 17 with SCA (age 55 ± 19.0 years, 8 men [47%]). The prevalence of SCA was 0.056%. SCA originated from the right sinus of Valsalva in 11 patients (65%) and from the left sinus of Valsalva in 6 subjects. According to Lipton's classification, the 17 SCAs were L1 (n = 5, 29%), L2-A (n = 1, 6%), R2-A (n = 2, 12%), R2-B (n = 6, 35%), R2-P (n = 2, 12%), and R3 (n = 1, 6%). (Lipton's classification consists of 3 groups and the division is based on the site of origin of SCA ["R" - right, "L" - left sinus of Valsalva] and its anatomical course relating to the ascending aorta and pulmonary trunk ["A" - anterior to the pulmonary trunk, "B" - between the aorta and pulmonary trunk, "P" - posterior to the aorta].) As compared with the reference group, SCA patients had shorter proximal trunks (5.0 ± 3.6 mm vs 8.6 ± 4.8 mm, p = 0.0012). The lumen area (LA) and lumen diameter of the proximal trunk in patients with SCA were larger than the LA and lumen diameter of the left main coronary artery from the reference group (49.5 ± 18.0 mm2 vs 21.3 ± 6.5 mm2, p <0.0001, and 7.8 ± 1.6 mm vs 5.1 ± 0.75 mm, p <0.0001, respectively). Moreover, the LA of the proximal SCA trunk was larger than the sum of respective measurement performed in left main coronary artery and proximal right coronary artery segments in the control group (49.5 ± 18.0 mm2 vs 34.0 ± 7.9mm2, p = 0.0001). In conclusion, the incidence of SCA is very low; but this condition is associated with significant enlargement of the proximal vessel segment.
单冠状动脉（SCA）是一种罕见的先天性异常。我们评估了通过冠状动脉计算机断层血管造影术诊断的 SCA 的患病率和解剖特征，并将近端 SCA 干的尺寸与 199 名正常冠状动脉的参考组进行了比较。我们筛选了 2008 年至 2018 年间接受冠状动脉计算机断层血管造影术的 30230 名患者，以确定 17 名 SCA 患者（年龄 55 ± 19.0 岁，8 名男性[47%]）。SCA 的患病率为 0.056%。SCA 起源于 11 名患者（65%）的右房室瓣窦和 6 名患者的左房室瓣窦。根据利pton 的分类，17 例 SCA 为 L1（n=5，29%），L2-A（n=1，6%），R2-A（n=2，12%），R2-B（n=6，35%），R2-P（n=2，12%）和 R3（n=1，6%）。（利pton 的分类包括 3 组，其分类依据是 SCA 的起源部位[“R”-右，“L”-右房室瓣窦]及其与升主动脉和肺动脉干的解剖关系[“A”-位于肺动脉干前，“B”-在主动脉和肺动脉干之间，“P”-在主动脉后]。）与参考组相比，SCA 患者的近端干较短（5.0 ± 3.6mm 与 8.6 ± 4.8mm，p=0.0012）。SCA 患者的近端干的管腔面积（LA）和管腔直径大于参考组左主干冠状动脉的 LA 和管腔直径（49.5 ± 18.0mm2 与 21.3 ± 6.5mm2，p<0.0001，7.8 ± 1.6mm 与 5.1 ± 0.75mm，p<0.0001，分别）。此外，SCA 近端干的 LA 大于对照组中左主干冠状动脉和近端右冠状动脉节段各自测量值之和（49.5 ± 18.0mm2 与 34.0 ± 7.9mm2，p=0.0001）。总之，SCA 的发病率很低；但这种情况与近端血管节段的显著增大有关。
