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与心脏手术相关的冠状动脉解剖学综合综述

Comprehensive Review of Coronary Artery Anatomy Relevant to Cardiac Surgery.

作者信息

Kesieme Emeka B, Omoregbee Benjamin, Ngaage Dumbor L, Danton Mark H D

机构信息

Department of Cardiothoracic Surgery, Castle Hill Hospital, Cottingham, United Kingdom.

Adult Cardiac Surgery, Castle Hill Hospital, Cottingham, United Kingdom.

出版信息

Curr Cardiol Rev. 2025;21(2):27-41. doi: 10.2174/011573403X321942241023112517.

Abstract

In order to perform safe cardiac surgery, a knowledge of applied coronary artery anatomy and its variants is essential for cardiac surgeons. In normal individuals, the right and the left coronary arteries arise from the corresponding sinuses of Valsalva within the aortic root. From the cardiac surgical perspective, the coronary artery is divided into the left main coronary artery, its branches (the left anterior descending artery and the circumflex artery), and the right coronary artery. With high-risk cardiac surgeries, including redo procedures, becoming increasingly performed, abnormal courses and variations of the coronary arteries, if not recognized, can predispose the patient to avoidable coronary injuries, resulting in adverse outcomes of cardiac surgical procedures. We aim to describe normal and applied coronary anatomy, common coronary artery variants previously reported, and their clinical relevance to both adult and paediatric cardiac surgery.

摘要

为了实施安全的心脏手术,心脏外科医生必须了解应用冠状动脉解剖结构及其变异情况。在正常个体中,右冠状动脉和左冠状动脉分别起自主动脉根部相应的主动脉窦。从心脏外科手术的角度来看,冠状动脉分为左冠状动脉主干、其分支(左前降支和回旋支)以及右冠状动脉。随着包括再次手术在内的高风险心脏手术越来越多地开展,如果未识别出冠状动脉的异常走行和变异,可能会使患者易遭受可避免的冠状动脉损伤,从而导致心脏手术出现不良后果。我们旨在描述正常及应用冠状动脉解剖结构、先前报道的常见冠状动脉变异情况及其在成人和小儿心脏手术中的临床意义。

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