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起源于肺动脉的异常左冠状动脉（ALCAPA）：彩色多普勒血流显像在识别罕见壁内走行中的关键作用

Anomalous Left Coronary Artery Arising from the Pulmonary Artery (ALCAPA): The Critically Important Role of Color Flow Doppler in Identifying a Rare Intramural Course.

作者信息

Harrison David J, Kane David A, Emani Sitaram M, Sanders Stephen P, Miller Thomas A, Marx Gerald R

机构信息

Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts.

Division of Pediatric, Cardiology, Barbara Bush Children's Hospital at Maine Medical Center, Portland, Maine.

出版信息

CASE (Phila). 2022 Mar 10;6(3):119-123. doi: 10.1016/j.case.2022.02.001. eCollection 2022 May.

DOI:10.1016/j.case.2022.02.001
PMID:35602985
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9120850/
Abstract

• ALCAPA must be considered in an infant with ischemia and/or heart failure. • A rare variant with intramural aortic course may appear normal on 2D echo. • Retrograde color flow in the LCA is highly suspicious for this lesion. • Ambiguous cases will benefit from multimodality imaging via catheterization or CT. • Early recognition may lead to lifesaving surgical correction.

摘要

• 对于患有缺血和/或心力衰竭的婴儿，必须考虑左冠状动脉异常起源于肺动脉（ALCAPA）。

• 一种罕见的壁内主动脉走行变异在二维超声心动图上可能表现正常。

• 左冠状动脉内的逆向血流高度怀疑为此病变。

• 不明确的病例将受益于通过导管插入术或CT的多模态成像。

• 早期识别可能会带来挽救生命的手术矫正。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/f6fbfb632950/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/b627f45c6a31/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/811eaf87d339/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/82a7896c1a7b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/52deb457c896/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/f6fbfb632950/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/b627f45c6a31/fx1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/811eaf87d339/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/82a7896c1a7b/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/52deb457c896/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/33a3/9120850/f6fbfb632950/gr4.jpg

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本文引用的文献

1
Intramural Aortic Course Should Always Be Considered for Anomalous Origin of the Left Coronary Artery From the Right Pulmonary Artery.对于左冠状动脉起源于右肺动脉的异常情况，应始终考虑主动脉壁内走行。
World J Pediatr Congenit Heart Surg. 2019 Jul;10(4):508-512. doi: 10.1177/2150135118799645. Epub 2019 Mar 27.
2
A curious course of an intramural anomalous left coronary artery from the pulmonary artery.一例起源于肺动脉的壁内异常左冠状动脉的罕见病例。
J Thorac Cardiovasc Surg. 2017 Mar;153(3):654-655. doi: 10.1016/j.jtcvs.2016.10.048. Epub 2016 Nov 3.
3
Surgical strategies for anomalous origin of the left coronary artery from the right pulmonary artery with an intramural aortic course: A report of 10 cases.
左冠状动脉异常起源于右肺动脉伴主动脉内走行的手术策略：10 例报告。
J Thorac Cardiovasc Surg. 2017 Mar;153(3):648-653. doi: 10.1016/j.jtcvs.2016.10.063. Epub 2016 Nov 12.
4
Surgical Intervention for Anomalous Origin of Left Coronary Artery From the Pulmonary Artery in Children: A Long-Term Follow-Up.儿童左冠状动脉起源于肺动脉异常的外科干预：长期随访
Ann Thorac Surg. 2016 May;101(5):1842-8. doi: 10.1016/j.athoracsur.2015.11.020. Epub 2016 Feb 18.
5
Coronary artery imaging in children.儿童冠状动脉成像
Korean J Radiol. 2015 Mar-Apr;16(2):239-50. doi: 10.3348/kjr.2015.16.2.239. Epub 2015 Feb 27.
6
Coronary CTA appearance of anomalous left coronary artery arising from the pulmonary artery with intramural aortic route.冠状动脉 CTA 显示起源于肺动脉的异常左冠状动脉伴主动脉内走行。
Int J Cardiovasc Imaging. 2014 Feb;30(2):241-3. doi: 10.1007/s10554-013-0334-3. Epub 2013 Nov 30.
7
Coronary imaging techniques with emphasis on CT and MRI.冠状动脉成像技术，重点介绍 CT 和 MRI。
Pediatr Radiol. 2011 Dec;41(12):1516-25. doi: 10.1007/s00247-011-2222-0. Epub 2011 Nov 30.
8
Anomalous left coronary artery from the pulmonary artery with an intramural course within the aortic wall: report of 3 surgical cases.起源于肺动脉的异常左冠状动脉并在主动脉壁内走行于壁间：3例手术病例报告
J Thorac Cardiovasc Surg. 2008 Mar;135(3):696-8. doi: 10.1016/j.jtcvs.2007.10.033.
9
Anomalous origin of the left coronary artery from the pulmonary artery with intramural aortic route: diagnosis and surgical treatment.左冠状动脉起源于肺动脉伴壁内主动脉走行：诊断与外科治疗
J Thorac Cardiovasc Surg. 1999 Apr;117(4):823-5. doi: 10.1016/S0022-5223(99)70306-5.
10
Diagnosis of anomalous left coronary artery by Doppler color flow mapping: distinction from other causes of dilated cardiomyopathy.通过多普勒彩色血流图诊断左冠状动脉异常：与扩张型心肌病的其他病因相鉴别。
J Am Coll Cardiol. 1992 May;19(6):1271-5. doi: 10.1016/0735-1097(92)90334-j.