Giannakopoulou Aikaterini, Chrysikos Dimosthenis, Spartalis Eleftherios, Protogerou Vasileios, Troupis Theodore
Department of Anatomy, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.
Propaedeutic Surgery, Laiko Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2021 Jun 18;13(6):e15751. doi: 10.7759/cureus.15751.
The left circumflex coronary artery anatomy is considered highly variable. Herein, we present a case of a 9-year-old male child with a remarkable medical history of a spontaneously closed interventricular septal defect, without residual regurgitation, who was referred for cardiological evaluation in view of orthopedic surgery. During the preoperative examination, echocardiography was performed, which showed multiple flows in the interventricular septum as well as a diastolic flow at the level of the pulmonary valve. Due to these findings, it was decided to perform a cardiac catheterization. On cardiac catheterization, it was diagnosed an anatomical variation of the circumflex branch of the left coronary artery arising from the main stem of the pulmonary artery. Significant stenosis was remarkable, as well as collateral circulation of both the circumflex and the left anterior descending artery with the right coronary artery. The child finally at the age of 11 underwent cardiothoracic surgery. To conclude, during asymptomatic cardiological evaluation, we should always think about the possibility of anatomic variations of the coronary arteries. Missing these types of anomalies may predispose to inadvertent life-threatening complications or sudden death.
左旋冠状动脉的解剖结构被认为高度变异。在此，我们报告一例9岁男性儿童病例，该患儿有室间隔缺损自然闭合且无残余反流的显著病史，因骨科手术而转诊进行心脏评估。术前检查期间，进行了超声心动图检查，结果显示室间隔有多处血流以及肺动脉瓣水平的舒张期血流。基于这些发现，决定进行心导管检查。在心导管检查中，诊断出左旋冠状动脉分支起源于肺动脉主干的解剖变异。显著狭窄明显，左旋支和左前降支与右冠状动脉之间也有侧支循环。该患儿最终在11岁时接受了心胸外科手术。总之，在无症状心脏评估期间，我们应始终考虑冠状动脉解剖变异的可能性。遗漏这类异常情况可能会导致意外的危及生命的并发症或猝死。
