Xu Xiaolan, Xu Peng, Wu Xiaoyan, Lin Hua, Chen Yinhua, Hu Xiaohua, Yu Jiangquan, Zheng Ruiqiang
Department of Intensive Care Medicine, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China.
Department of Hepatobiliary and Pancreatic Surgery, Northern Jiangsu People's Hospital, Clinical Medical College of Yangzhou University, Yangzhou, China.
Front Med (Lausanne). 2022 Jun 29;9:936721. doi: 10.3389/fmed.2022.936721. eCollection 2022.
Anomalous origin of a coronary artery (AOCA) is defined as the failure of the coronary artery to originate from the normal coronary sinus. The anomalous origin of the left coronary artery arising from the right coronary sinus is rare, dangerous and at risk of malignant arrhythmia, sudden death, and high mortality.
In this study, we present a 14-year-old adolescent male who went to a hospital with transient unconsciousness after exercise, who subsequently developed cardio arrest due to malignant arrhythmia. He was admitted to the intensive care unit, and who subsequently received successful veno-arterial extracorporeal membrane oxygenation (VA ECMO) assisted circulation followed by intra-aortic balloon counterpulsation (IABP). Echocardiography and cardiac CTA were also performed, further confirming that the abnormal left coronary artery originated from the right coronary sinus. The patient subsequently underwent heart surgery.
The successful treatment of the patient in this report was attributed to the immediately VA ECMO, supplemented by IABP. Establishing clear diagnosis is a process of multidisciplinary joint diagnosis, which provides a reference for clinicians when encountering similar cases.
冠状动脉异常起源（AOCA）被定义为冠状动脉未能从正常冠状窦起源。左冠状动脉起源于右冠状窦的异常情况罕见、危险，存在恶性心律失常、猝死风险且死亡率高。
在本研究中，我们报告一名14岁青少年男性，其运动后出现短暂意识丧失，随后因恶性心律失常发生心脏骤停。他被收入重症监护病房，随后成功接受静脉-动脉体外膜肺氧合（VA ECMO）辅助循环，之后进行主动脉内球囊反搏（IABP）。还进行了超声心动图和心脏CTA检查，进一步证实异常左冠状动脉起源于右冠状窦。该患者随后接受了心脏手术。
本报告中患者的成功治疗归因于立即进行VA ECMO，并辅以IABP。明确诊断是一个多学科联合诊断的过程，为临床医生遇到类似病例时提供参考。
