Bashyal Krishnaprasad, Koirala Bhagawan, Bhattarai Anil, Baral Ravi Kumar, Khakural Prabhat, Shakya Samir, Kadel Prashiddha Bikram
Department of Cardiac Surgery, Manmohan Cardiothoracic Vascular and Transplant Center, TUTH, Kathmandu, Nepal.
Department of Pediatric Cardiology, Manmohan Cardiothoracic Vascular and Transplant Center, TUTH, Kathmandu, Nepal.
J Surg Case Rep. 2022 Jul 4;2022(7):rjac310. doi: 10.1093/jscr/rjac310. eCollection 2022 Jul.
The incidence of coronary artery anomalies (CAAs) is 0.2-1.2% of the population. Its paradox of being a rare entity with presentation ranging from sudden cardiac death, congestive heart failure, myocardial infarction to being clinically silent, asserts a challenge to its treating physician. Among the various major categories of CAA, we describe four different types of these anomalies in our retrospective evaluation over 2 years. They include - coronary cameral fistula with coronary aneurysm, congenital atresia of left main, anomalous aortic origin of left anterior descending (LAD) and circumflex artery (LCx) with malignant LAD course, anomalous origin of left coronary artery from pulmonary artery (ALCAPA). Although the child with ALCAPA succumbed despite every possible and available timely efforts, other patients had good postoperative recovery and a brief hospital stay.
冠状动脉异常（CAA）的发生率在人群中为0.2%-1.2%。其表现从心源性猝死、充血性心力衰竭、心肌梗死到临床无症状，作为一种罕见疾病却具有这种矛盾性，给其治疗医生带来了挑战。在CAA的各种主要类型中，我们在2年的回顾性评估中描述了四种不同类型的此类异常。它们包括——冠状动脉瘤合并冠状动脉心腔瘘、左主干先天性闭锁、左前降支（LAD）和回旋支（LCx）起源于主动脉异常且LAD走行不良、左冠状动脉起源于肺动脉（ALCAPA）。尽管患有ALCAPA的患儿尽管尽了一切可能且及时的努力仍死亡，但其他患者术后恢复良好且住院时间短暂。
