摘要
目的 :探讨冠状动脉造影的人群中冠状动脉畸形的检出率、临床特点和预后。 方法 :回顾性总结 3 188例行冠状动脉造影术的人群。 结果 :3 188例行冠状动脉造影术的人群中 ,共检出冠状动脉畸形 42例 ,检出率为 1 3 2 % ,其中 81%为冠状动脉起源和分布异常 ,19%为冠状动脉静脉瘘 ;76 2 %为对心肌灌注没有影响、相对良性的畸形 ,2 3 8%为对心肌灌注有潜在影响、有一定的危险性的畸形。 结论 :右冠状动脉起源于左冠状动脉窦、左主干起源于右冠状动脉窦并穿行于主动脉和肺动脉之间、左主干起自肺动脉等是非常严重的冠状动脉畸形 ,患者常发生心绞痛、急性心肌梗死和心力衰竭 ,这些畸形一旦发现 ,应进行预防性的手术矫正。小冠状动脉瘘多数无临床症状 ,但多发和大冠状动脉瘘可发生充血性心力衰竭、心肌缺血。冠状动脉畸形并非罕见 ,某些类型的冠状动脉畸形可致严重的临床后果 。
Objective: To study the detection rate of co ronary artery anomalies (CAA) in the population undergoing coronary angiograph y (CAG), th eir clinical features and prognosis. Methods: Retrospective review of the clin ical features of 3 188 patients undergoing CAG was made i n our hospital. Results: Among 3 188 patients, 42 had CAA. The total detection rate was 1 32%. Th e anomalous RCA originated from the left si nus, and the left main coronary arter y (LMCA) from the right sinus betw ee n the aorta and the pulmonary artery trunk . Anomalous LMCA from the pulmonary artery t runk was the most serious CAA bec ause they werw able to cause ischemia and ac ute myocardial infarction. Conclusions: When LMCA or RCA originates from its opposite sinus, the interarter ial course between aorta and pulmonary arte ry trunk is the most serious CAA, bec ause it can cause ischemia, leading to sudde n deat h. Revascularization in these patients is i ndicated.
出处
《中国循环杂志》
CSCD
北大核心
2003年第5期349-351,共3页
Chinese Circulation Journal
