Chopra P S, Reed W H, Wilson A D, Rao P S
Department of Surgery, University of Wisconsin Medical School, Madison.
Chest. 1994 Dec;106(6):1920-2. doi: 10.1378/chest.106.6.1920.
Anomalous origin of the circumflex coronary artery is extremely rare and may cause serious perioperative myocardial injury associated with correction of coexisting congenital malformations. We describe a 15-year-old female patient who underwent surgical correction of an aortopulmonary window at 13 months. Fourteen years later, she presented with dyspnea on exertion associated with angina. On cardiac catheterization, she was noted to have a step-up in oxygen saturation in the pulmonary artery and retrograde filling of the circumflex coronary artery from the left anterior descending coronary artery, with drainage into the pulmonary artery. The patient underwent surgical bypass of the anomalous circumflex coronary artery and ligation of its anomalous origin in the pulmonary artery. Her postoperative course was uneventful, with complete relief of symptoms. We have reviewed this rare congenital anomaly and its therapeutic options.
回旋支冠状动脉异常起源极为罕见，可能会在矫正并存的先天性畸形时导致严重的围手术期心肌损伤。我们描述了一名15岁女性患者，她在13个月大时接受了主肺动脉窗的手术矫正。14年后，她出现劳力性呼吸困难并伴有心绞痛。心脏导管检查发现，她的肺动脉血氧饱和度升高，回旋支冠状动脉从左前降支冠状动脉逆行充盈，并引流至肺动脉。该患者接受了异常回旋支冠状动脉的外科搭桥手术，并结扎了其在肺动脉中的异常起源。她术后恢复顺利，症状完全缓解。我们回顾了这种罕见的先天性异常及其治疗选择。
