Division of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea.
Heart Surg Forum. 2020 Sep 15;23(5):E665-E667. doi: 10.1532/hsf.3143.
Herein, we present a brief case of anomalous coronary arteries mistaken to be chronic total occlusion. Since we first presumed the anomalous coronary arteries to be chronic total occlusion of the distal right coronary artery, percutaneous coronary intervention was attempted for the presumed lesion, but it failed. Before the second attempt of percutaneous coronary intervention, coronary computed tomography angiography revealed the coronary artery from the left anterior descending artery corresponding with the distal part of the right coronary artery without connection to the right coronary artery. Therefore, we recognized the patient had anomalous coronary arteries with no connection of the vascular wall between the main and distal segments of the right coronary artery. This case may give insights to the importance of meticulous examination of coronary computed tomography angiography imaging before chronic total occlusion percutaneous coronary intervention to avoid the unnecessary procedure.
在此，我们报告一例误诊为慢性完全闭塞的异常冠状动脉。由于我们最初推测异常冠状动脉为右冠状动脉远端慢性完全闭塞，因此尝试对疑似病变进行经皮冠状动脉介入治疗，但失败了。在第二次经皮冠状动脉介入治疗之前，冠状动脉计算机断层血管造影显示来自左前降支的冠状动脉与右冠状动脉的远端相对应，与右冠状动脉没有连接。因此，我们认识到患者的右冠状动脉主段和远端之间的血管壁没有连接，存在异常冠状动脉。这个病例可能提示我们在进行慢性完全闭塞经皮冠状动脉介入治疗之前，仔细检查冠状动脉计算机断层血管造影图像的重要性，以避免不必要的操作。
