Kimbiris D
Am J Cardiol. 1985 Mar 1;55(6):765-9. doi: 10.1016/0002-9149(85)90153-5.
The clinical and angiographic findings in 10 patients with anomalous origin of the left main (LM) coronary artery from the right sinus of Valsalva are presented. The initial course of the anomalous artery was between the aorta and the pulmonary trunk in 6 patients (5 men and 1 woman), and posterior to the aorta in 4 patients (3 women and 1 man). The best coronary angiographic projection to determine the course of the LM coronary artery in relation to the aorta and pulmonary trunk was the right anterior oblique and lateral projections, with a catheter in the pulmonary trunk as a guide. In the right anterior oblique projection left ventriculogram, an increased density at the base of the aorta was seen in all patients with posterior-to-aorta course of the anomalous artery. The blood supply to the first portion of the ventricular septum is provided by 1 or 2 descending septal branches from the anomalous LM artery, when the anomalous vessel is coursing between the aorta and pulmonary trunk. When the anomalous LM courses posteriorly to the aorta, it does not provide any septal branches. In patients with this anomaly, the blood supply to the first portion of the septum is usually provided by descending septal branches originating from the right sinus of Valsalva or from the first portion of the right coronary artery. Six of the 10 patients had severe obstructive coronary artery disease. Four of the 6 patients had significant LM coronary artery disease.
本文报告了10例左主冠状动脉起源于右冠状动脉窦的患者的临床和血管造影结果。6例患者（5例男性和1例女性）的异常动脉起始段位于主动脉和肺动脉干之间，4例患者（3例女性和1例男性）的异常动脉起始段位于主动脉后方。以肺动脉干内的导管为引导，确定左主冠状动脉相对于主动脉和肺动脉干走行的最佳冠状动脉造影投照角度是右前斜位和侧位投照。在右前斜位左心室造影中，所有异常动脉走行于主动脉后方的患者，主动脉根部密度均增加。当异常左主冠状动脉走行于主动脉和肺动脉干之间时，室间隔第一部分的血供由异常左主冠状动脉的1或2支降隔支提供。当异常左主冠状动脉走行于主动脉后方时，它不发出任何隔支。在患有这种异常的患者中，室间隔第一部分的血供通常由起源于右冠状动脉窦或右冠状动脉第一部分的降隔支提供。10例患者中有6例患有严重的阻塞性冠状动脉疾病。6例患者中有4例患有严重的左主冠状动脉疾病。
