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起源于右冠状动脉窦的左主干异常伴心源性猝死:机械循环支持的作用

Anomalous origin of the left main from the right coronary sinus presenting with sudden cardiac death: utility of mechanical circulatory support.

作者信息

Al Hennawi Hussam Eddin T, Fahsah Ibrahim, Mathbout Mohammad F

机构信息

Al Faisal University, College of Medicine Riyadh, Saudi Arabia.

Norton Healthcare, Department of Cardiology, Louisville, Kentucky, USA.

出版信息

Glob Cardiol Sci Pract. 2021 Oct 30;2021(3):e202124. doi: 10.21542/gcsp.2021.24.

Abstract

Anomalies involving the origin of the coronary arteries are extremely rare, with the left main artery coronary artery (LMCA) originating from the right coronary sinus (RCS) one of its rarest forms. Anomalous origin of left main from right coronary sinus poses a high risk of sudden cardiac arrest. In our report, we shed light on the case of a 43-year-old female who suffered a witnessed cardiac arrest due to underlying anomalous origin of the left main artery from right coronary sinus. The patient was initially pronounced dead until return of spontaneous rhythm with concomitant myocardial infarction led to the diagnosis of anomalous coronary artery. This case stresses important points to consider when dealing with the acute management and chronic treatment plan for this subset of high-risk patients. We also consider the utility of mechanical circulatory support in the management of this condition.

摘要

涉及冠状动脉起源的异常极为罕见,左冠状动脉主干(LMCA)起源于右冠状动脉窦(RCS)是其最罕见的形式之一。左主干起源于右冠状动脉窦会带来心脏骤停的高风险。在我们的报告中,我们阐述了一名43岁女性的病例,该女性因左主干动脉起源于右冠状动脉窦这一潜在异常情况而发生了心脏骤停,且有目击者。该患者最初被宣布死亡,直到自发心律恢复并伴有心肌梗死才得以诊断出冠状动脉异常。该病例强调了在处理这类高危患者的急性管理和慢性治疗方案时需要考虑的要点。我们还探讨了机械循环支持在这种情况下的应用价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11d2/8587346/bc386b0e4e64/gcsp-2021-3-e202124-g001.jpg

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