Phadke Milind, Ambardekar Ketan, Shaikh Zohaib, Mahajan A U, Nathani P J
Additional Professor, Department of Cardiology, L.T.M.G. Hospital, Mumbai, Maharashtra.
Assistant Professor, Department of Cardiology, L.T.M.G. Hospital, Mumbai, Maharashtra.
J Assoc Physicians India. 2020 Sep;68(9):28-32.
A Cross Sectional Observation study was conducted at Department of Cardiology, in a tertiary Hospital for a period of 3 years. Patients undergoing Coronary Angiography (CAG) were screened and patients having Anomalous Coronary Origin from the Opposite or Non-Coronary Sinus of Valsalva were selected. CT Cronary Angiography was done in all such patients and the course of the anomalous artery was studied.
During the 3 years period of study, total of 5241 CAGs were conducted of which 42 (0.8%) patients were found to have Anomalous Coronary Artery Origin as per the inclusion criteria. Out of the 42 cases, Anomalous origin of RCA from Left Corornary Cusp was the commonest with 23(0.43%) cases, followed by Anomalous Origin of LCX from Right Coronary or RCC with 17 (0.32%) cases. Other anomalies of origin were quite rare (n=2) which included Anomalous origin of Left Main from RCA (n=1) and Dual origin of LAD (n=1). CT Coronary Angiography showed that of the 23 patients with Anomalous Origin of RCA from Left side,27.4% had Inter-Arterial course and 56.1% had Retro-Aortic course. Of the 17 patients with Anomalous Origin of LCX from Right sinus, 88.23% had Retro-Aortic course.
This study showed that anomalous origin of Coronary Artery from the opposite sinus is quite rare with RCA from Left Sinus and LCX from Right sinus comprised the vast majority of cases. Most of these anomalous Coronaries have on benign course as defined on CT Coronary Angiography. However, it is important to recognize to delineate the origin and course as it can have significant clinical, therapeutic and prognostic implications.
在一家三级医院的心脏病科进行了一项为期3年的横断面观察研究。对接受冠状动脉造影（CAG）的患者进行筛查，选取冠状动脉起源于对侧或瓦氏窦非冠状动脉窦的患者。对所有此类患者进行CT冠状动脉造影，并研究异常动脉的走行。
在3年的研究期间，共进行了5241例CAG，其中42例（0.8%）患者根据纳入标准被发现有冠状动脉异常起源。在这42例病例中，右冠状动脉起源于左冠状动脉窦最为常见，有23例（0.43%），其次是左旋支起源于右冠状动脉或右冠状动脉窦，有17例（0.32%）。其他起源异常相当罕见（n = 2），包括左主干起源于右冠状动脉（n = 1）和左前降支双起源（n = 1）。CT冠状动脉造影显示，在23例右冠状动脉起源于左侧的患者中，27.4%有动脉间走行，56.1%有主动脉后走行。在17例左旋支起源于右窦的患者中，88.23%有主动脉后走行。
本研究表明，冠状动脉起源于对侧窦相当罕见，绝大多数病例为右冠状动脉起源于左窦和左旋支起源于右窦。这些异常冠状动脉大多在CT冠状动脉造影定义的良性走行上。然而，识别其起源和走行很重要，因为这可能具有重要的临床、治疗和预后意义。
