López Candel J, Pinar E, López Candel E, Vicente Vera T, Pérez Lorente F, Roldán Conesa D, Soria F, García Reverte J, Valdés Chávarri M
Servicio de Cardiología, Hospital General Universitario, Murcia.
Rev Esp Cardiol. 1995 Mar;48(3):208-10.
We present the case of an old patient with coronary artery disease and two previous myocardial infarctions, admitted to the hospital by syncopal episodes, in which the coronariographic study showed the ectopic origin of the left main coronary artery in the right sinus of Valsalva with anomalous course between the aortic and pulmonary arteries. In this case the initial coronariographic diagnosis and the therapeutical attitude (initially aggressive only in cases of interarterial course) was confirmed by mean of transesophageal echocardiography, showing a better topographical definition of the ectopic vessel aberrant course, although due to the high degree of left ventricular disfunction and the diffuse disease of distal vessels in this patient, CABG surgery was avoided. The angiographic feature is described and the transesophageal approach is remarked as a complementary diagnostic tool in the correct definition of the anomalous course.
我们报告了一例患有冠状动脉疾病且曾有两次心肌梗死的老年患者，因晕厥发作入院。冠状动脉造影研究显示左主冠状动脉起源于右冠窦，走行于主动脉和肺动脉之间。在该病例中，经食管超声心动图证实了最初的冠状动脉造影诊断及治疗方案（仅在动脉间走行的情况下最初采取积极治疗），尽管由于该患者左心室功能障碍程度高且远端血管弥漫性病变，避免了冠状动脉旁路移植术（CABG），但经食管超声心动图能更好地明确异位血管的异常走行。本文描述了血管造影特征，并强调经食管超声心动图作为一种辅助诊断工具，在正确界定异常走行方面的作用。
