Taguchi Ryo, Kowatari Ryosuke, Minakawa Masahito, Daitoku Kazuyuki, Fukuda Ikuo
Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori, 036-8562, Japan.
Gen Thorac Cardiovasc Surg. 2021 Aug;69(8):1251-1253. doi: 10.1007/s11748-021-01644-y. Epub 2021 May 12.
A 35-year-old man presented with an anomalous right coronary artery from the opposite Valsalva sinus. He developed an aorto-right-atrial fistula due to destructive infective endocarditis undetected during preoperative computed tomography. Intraoperative retrograde cardioplegia and direct insertion of the coronary probe demonstrated that the right coronary ostium was in the left Valsalva sinus near the left coronary ostium. The right-sided aortic root and right atrium were severely damaged. This coronary anomaly allowed us to perform a unique aortic root reconstruction without touching or injuring the right coronary artery. Two years later, the patient remains well without complications. This novel reconstruction treatment is feasible for destructive infective endocarditis in such patients.
一名35岁男性患者，其右冠状动脉起源于对侧的瓦尔萨尔瓦窦。由于术前计算机断层扫描未检测到的破坏性感染性心内膜炎，他发展为主动脉 - 右心房瘘。术中逆行心脏停搏和冠状动脉探子的直接插入显示，右冠状动脉开口位于左冠状动脉开口附近的左瓦尔萨尔瓦窦内。右侧主动脉根部和右心房严重受损。这种冠状动脉异常使我们能够在不触及或损伤右冠状动脉的情况下进行独特的主动脉根部重建。两年后，患者情况良好，无并发症。这种新颖的重建治疗对于此类患者的破坏性感染性心内膜炎是可行的。
