Hekmat V, Rao S M, Chhabra M, Chiavarelli M, Anderson J E, Nudel D B
Department of Pediatrics, SUNY/HSCB, Brooklyn 11203-2098, USA.
Clin Cardiol. 1998 Oct;21(10):773-6. doi: 10.1002/clc.4960211016.
Anomalous origin of the right coronary artery (ARCA) from the main pulmonary artery (MPA) is a rare congenital anomaly, with only 18 reported cases in the pediatric age group. More than half of these had associated cardiac anomalies that masked the presence of ARCA. Conversely, in many patients with ARCA as an isolated anomaly, the diagnosis has been missed during lifetime. The only patient with an isolated ARCA who was diagnosed in infancy presented with congestive heart failure. Asymptomatic infants with ARCA from the MPA have not been previously reported. Three additional cases, two infants and a child with ARCA from the MPA, are reported in this paper. The diagnostic dilemmas and the prognosis are discussed and management is recommended.
右冠状动脉起源于主肺动脉(ARCA)是一种罕见的先天性异常,小儿年龄组中仅有18例报告病例。其中一半以上伴有心脏异常,掩盖了ARCA的存在。相反,在许多以ARCA为孤立异常的患者中,一生中都未被诊断出来。唯一在婴儿期被诊断为孤立性ARCA的患者出现了充血性心力衰竭。此前尚未报道过MPA起源的ARCA无症状婴儿。本文报告另外3例病例,2例婴儿和1例儿童的MPA起源的ARCA。讨论了诊断难题和预后,并提出了管理建议。