Househam K C, Human D G, Fraser C B, Joffe H S
S Afr Med J. 1983 Feb 26;63(9):325-7.
An anomalous left coronary artery from the pulmonary artery was diagnosed clinically in 12 patients (and confirmed angiographically in 11 and at autopsy in 1). A classic history of 'infantile angina' was obtained in only 1 patient, while the typical electrocardiographic findings of anterolateral ischaemia or infarction were present in 11 patients (92%). The majority had evidence of left ventricular dysfunction and mitral regurgitation. Three patients underwent surgical reimplantation of the anomalous left coronary artery into the ascending aorta. Two survive, but with persistent electrocardiographic changes and cardiomegaly. Nine patients, of whom 4 survive, were managed medically. Five of the 6 deaths occurred within 1 month of diagnosis. A conservative approach to surgical intervention is recommended, as surgery is unlikely to alter the ultimate prognosis.
临床上诊断出12例患者存在起源于肺动脉的异常左冠状动脉（11例经血管造影证实，1例经尸检证实）。仅1例患者有典型的“婴儿型心绞痛”病史，而11例患者（92%）出现前外侧缺血或梗死的典型心电图表现。大多数患者有左心室功能障碍和二尖瓣反流的证据。3例患者接受了将异常左冠状动脉重新植入升主动脉的手术。2例存活，但仍有持续的心电图改变和心脏扩大。9例患者接受药物治疗，其中4例存活。6例死亡患者中有5例在诊断后1个月内死亡。建议对手术干预采取保守方法，因为手术不太可能改变最终预后。
