Naito Yuji, Suzuki Fumitaka, Murakami Tatsuya
Department of Thoracic Surgery, Asahikawa City Hospital, 1-65, Kinsei-cho, Asahikawa, Hokkaido, 070-8610, Japan.
Gen Thorac Cardiovasc Surg Cases. 2025 Mar 31;4(1):19. doi: 10.1186/s44215-025-00204-7.
Congenital coronary artery anomalies complicated with aortic dissection are rare. We experienced a patient with a single coronary artery presenting with a type A dissecting aortic aneurysm. A 77-year-old woman who experienced sudden back pain and was diagnosed with type A acute aortic dissection was initially treated conservatively because the false lumen thrombosed entirely. Computed tomography taken during 5 weeks of hospitalization incidentally revealed an anomalous single coronary artery arising from the left sinus of Valsalva, and the right coronary artery orifice was absent. One month after being transferred to another institution for rehabilitation, she was reintroduced to us for re-dissection of the aorta. An urgent operation involving aortic arch replacement was performed. There was a solitary coronary artery orifice at the left sinus of Valsalva and no ostium at the right sinus. The postoperative course was uneventful, and the patient was discharged 14 days after the surgery. Only 3 cases involving a single coronary artery complicated with dissecting aortic aneurysm have been reported previously.
先天性冠状动脉异常合并主动脉夹层很少见。我们遇到了一名单支冠状动脉患者，其表现为A型主动脉夹层动脉瘤。一名77岁女性，突发背痛，被诊断为A型急性主动脉夹层，最初采取保守治疗，因为假腔完全血栓形成。住院5周期间进行的计算机断层扫描偶然发现一条异常的单支冠状动脉起源于主动脉左窦，右冠状动脉开口缺失。转至另一机构进行康复治疗1个月后，她因主动脉再次夹层被转诊至我们这里。进行了包括主动脉弓置换在内的紧急手术。主动脉左窦有一个单独的冠状动脉开口，右窦无开口。术后过程顺利，患者术后14天出院。此前仅报道过3例单支冠状动脉合并主动脉夹层动脉瘤的病例。
