Helal Ayman, Farooq Mohsin, Alama Mohamed, Antoun Ibrahim
Department of Cardiology, Kettering General Hospital, University Hospitals of Northamptonshire (UHN), Kettering, UK.
Cardiology imaging, Department of Cardiology, Kettering General Hospital, University Hospitals of Northamptonshire (UHN), Kettering, UK.
Case Rep Cardiol. 2025 May 12;2025:8125980. doi: 10.1155/cric/8125980. eCollection 2025.
A 67-year-old male presented with non-ST elevation myocardial infarction (NSTEMI) with underlying anomalous origin of the right coronary artery (RCA) and a malignant course between the aorta and pulmonary artery. Previous CABG with LIMA and RIMA grafts had failed, leaving the patient with severe in-stent restenosis (ISR) in the LAD and degenerated, blocked grafts. The patient underwent percutaneous coronary intervention (PCI) to the anomalous RCA, which posed challenges in engagement due to its anomalous course. This case report discusses the complexities of managing such anatomies, emphasizing the role of CT coronary angiography, the difficulty of engaging anomalous arteries, and the techniques used to achieve successful PCI.
一名67岁男性因非ST段抬高型心肌梗死（NSTEMI）就诊，其右冠状动脉（RCA）存在先天性异常起源，走行于主动脉和肺动脉之间且病情凶险。既往行左内乳动脉（LIMA）和右内乳动脉（RIMA）搭桥手术失败，患者左前降支（LAD）出现严重支架内再狭窄（ISR），移植血管退化、堵塞。患者接受了对异常RCA的经皮冠状动脉介入治疗（PCI），因其异常走行，导管插入面临挑战。本病例报告讨论了处理此类解剖结构的复杂性，强调了CT冠状动脉造影的作用、异常动脉导管插入的困难以及成功实施PCI所采用的技术。
