The University of Adelaide, Adelaide Medical School, Adelaide, SA, Australia.
Forensic Science SA, Adelaide, SA, Australia.
Pediatr Dev Pathol. 2024 May-Jun;27(3):275-277. doi: 10.1177/10935266231221710. Epub 2024 Jan 14.
A 1-week-old girl died suddenly and unexpectedly. At autopsy the major finding was of a right dominant coronary artery circulation with an inapparent left coronary artery ostium. After careful examination, an anomalous origin of the left coronary artery was found with the ostium located in the non-coronary cusp immediately adjacent to the commissure of the non- and left coronary cusps. The ostium was of small caliber with an obliquely oriented artery (<45°) with no ostial ridges. The artery coursed anteriorly past the left coronary cusp between the aorta and the left atrial appendage to then follow its usual course inferiorly along the anterior aspect of the left ventricle. The reminder of the autopsy was unremarkable. Death was, therefore, attributed to an anomalous and hypoplastic left coronary artery (and ostium) with an acute angle of take-off. Tracing coronary arteries in the very young may be technically difficult due to their small size, thus identifying the location of ostia is important. This may be difficult when the ostium was located close to a commissure.
一名 1 周大的女婴突然且意外死亡。尸检的主要发现是右优势型冠状动脉循环，左冠状动脉口不明显。经过仔细检查，发现左冠状动脉异常起源，开口位于紧邻非冠状动脉和左冠状动脉瓣交界处的非冠状动脉瓣。口部口径较小，动脉呈斜向（<45°），无口嵴。动脉从前向后穿过左冠状动脉瓣，位于主动脉和左心耳之间，然后沿着左心室前表面向下走行。尸检的其余部分未见异常。因此，死因被归结为左冠状动脉（和口）异常和发育不良，其起始角度呈锐角。由于冠状动脉较小，在非常年幼的儿童中追踪冠状动脉可能具有技术难度，因此确定口的位置很重要。当口部靠近交界处时，这可能很困难。
