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一名患有四叶式主动脉瓣和左冠状动脉异常主动脉起源的年轻男性患者的冠状动脉下ROSS手术:病例报告

Sub-coronary ROSS operation in a young man with quadricuspid aortic valve and anomalous aortic origin of the left coronary artery: A case report.

作者信息

Xu Li, Su Yueqiu, Leng Zhou

机构信息

Operating Room, Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.

Department of Anesthesiology, West China Hospital, Sichuan University/West China School of Nursing, Chengdu, Sichuan, China.

出版信息

Medicine (Baltimore). 2025 Jan 17;104(3):e41302. doi: 10.1097/MD.0000000000041302.

Abstract

RATIONALE

Quadricuspid aortic valve (QAV) is a rare condition with a very low incidence. Anomalous aortic origin of a coronary artery (AAOCA) is the most prevalent form of coronary anomaly. One variant of AAOCA is the anomalous aortic origin of the left coronary artery from the right coronary sinus (L-AAOCA). It is even rarer for QAV to occur in combination with AAOCA.

PATIENT CONCERNS

In this case report, we present a patient who was diagnosed with QAV and L-AAOCA using preoperative transesophageal echocardiography and 3-dimensional computed tomography (3D-CT).

DIAGNOSES

Cardiac-enhanced CT showed an anomalous aortic origin of the left coronary artery from the right coronary sinus with an intramural course.

INTERVENTIONS

The patient underwent sub-coronary ROSS procedure along with the unroofing procedure.

OUTCOMES

The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.

LESSONS

The timely diagnosis of this incorporated cardiac anomaly, or rather its accidental discovery, led to successful surgical correction, eliminating the future risk of cardiac ischemia or SCD.

摘要

理论依据

四叶式主动脉瓣(QAV)是一种罕见疾病,发病率极低。冠状动脉异常起源于主动脉(AAOCA)是冠状动脉异常中最常见的形式。AAOCA的一种变异形式是左冠状动脉异常起源于右冠状动脉窦(L-AAOCA)。QAV合并AAOCA的情况更为罕见。

患者情况

在本病例报告中,我们介绍了一名患者,该患者术前经食管超声心动图和三维计算机断层扫描(3D-CT)诊断为QAV和L-AAOCA。

诊断

心脏增强CT显示左冠状动脉异常起源于右冠状动脉窦,走行于心肌内。

干预措施

患者接受了冠状动脉下ROSS手术及开窗手术。

结果

这种合并心脏异常的及时诊断,或者更确切地说是偶然发现,导致了成功的手术矫正,消除了未来心脏缺血或心源性猝死的风险。

经验教训

这种合并心脏异常的及时诊断,或者更确切地说是偶然发现,导致了成功的手术矫正,消除了未来心脏缺血或心源性猝死的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/72d0/11749646/1379bc5ffbfe/medi-104-e41302-g001.jpg

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