Radke P W, Messmer B J, Haager P K, Klues H G
Medical Clinic I and Department of Cardiothoracic Surgery, RWTH University Hospital, Aachen, Germany.
Ann Thorac Surg. 1998 Oct;66(4):1444-9. doi: 10.1016/s0003-4975(98)00716-4.
Anomalous origin of the right coronary artery from the main pulmonary artery is a rare congenital cardiac malformation. Most patients remain asymptomatic. However, there are cases of sudden cardiac death described in the literature, indicating a potentially malign course of the disease. To establish a double-ostium coronary system, correction of the aberrant vessel is recommended. Despite surgical reconstitution of normal coronary anatomy, the postoperative clinical presentation of some patients does not improve substantially, raising the question of the functional outcome of reinserted coronary vessels. This report of a patient with anomalous origin of the right coronary artery from the pulmonary trunk, in whom a complete hemodynamic assessment including intracoronary Doppler flow measurements was performed before and after reimplantation, very strongly supports the concept of an anatomically corrective operation.
右冠状动脉起源于主肺动脉是一种罕见的先天性心脏畸形。大多数患者无症状。然而，文献中描述了一些心脏性猝死的病例，提示该疾病可能有恶性病程。为建立双开口冠状动脉系统，建议矫正异常血管。尽管手术重建了正常的冠状动脉解剖结构，但部分患者术后临床表现并未显著改善，这引发了重新植入的冠状动脉血管功能转归的问题。本报告介绍了一名右冠状动脉起源于肺动脉干的患者，在重新植入前后进行了包括冠状动脉内多普勒血流测量在内的全面血流动力学评估，这有力地支持了解剖矫正手术的理念。
