Fujiwara T, Nogami A, Yamane H, Yoshida H, Fukuhiro Y, Tabuchi A, Katsumura T
Department of Thoracic Surgery, Kawasaki Medical School, Kurashiki, Japan.
Kyobu Geka. 1993 Jun;46(6):477-81.
An adult case of anomalous origin of left coronary artery from pulmonary trunk was reported. The catheterization studies revealed significant amount of left to right shunt in the pulmonary trunk and anomalous origin of left coronary artery from pulmonary artery with well developed and marked tortuously dilated collaterals from the right coronary artery. During surgery, blood flow waveforms of the LAD was measured using pulsed Doppler velocimeter. After temporary closing of the origin of left coronary artery, blood flow of the LAD markedly decreased. A-C bypass grafting to LAD was performed successfully using saphenous vein and graft flow rate was 220 ml/min. These findings suggest that the coronary blood flow through the tortuously dilated collaterals after ligation of the origin of left coronary artery was insufficient to perfuse the left coronary artery.
报告了一例成人左冠状动脉起源于肺动脉干的病例。心导管检查显示肺动脉干存在大量左向右分流，左冠状动脉起源于肺动脉，右冠状动脉有发育良好且明显迂曲扩张的侧支循环。手术过程中，使用脉冲多普勒测速仪测量了左前降支（LAD）的血流波形。在暂时闭合左冠状动脉起源处后，LAD的血流明显减少。使用大隐静脉成功地进行了LAD的A-C旁路移植术，移植血流量为220毫升/分钟。这些发现表明，结扎左冠状动脉起源处后，通过迂曲扩张侧支循环的冠状动脉血流不足以灌注左冠状动脉。
