老年人冠状动脉起源异常的影像特征及其临床意义

目的探讨老年人冠状动脉(冠脉)起源异常(AOCA)的影像特征及其临床意义。方法对22例年龄≥65岁的老年AOCA患者的影像和临床资料进行回顾性分析。结果22例AOCA患者平均年龄(71±5)岁,均合并1种以上其他心血管病。其中良性AOCA17例(占77.3%),包括前降支和回旋支分别开口于左冠窦9例,回旋支起源于右冠窦3例,右冠脉起源于升主动脉3例,回旋支发育不良2例;有潜在临床危险AOCA5例(占22.7%),分别为左主干起源于右冠窦1例,右冠脉起源于左冠窦2例,单支左冠脉2例。对有潜在临床危险AOCA患者随访1～6年,未发现起源异常动脉与患者心脏事件有明确关系。结论老年人AOCA无特征性临床表现,通常在行冠脉影像学检查时被发现;老年人AO-CA似乎并不导致明显的临床后果。

Angiographic characteristics and clinical significance in elderly patients with anomalous origin of coronary artery

ObjectiveTo investigate the angiographic characteristics of anomalous origin of coronary artery(AOCA) in the elderly,and to evaluate their clinical significance.MethodsThe clinical data and angiographic characteristics in 22 elderly patients(age≥65 years) with AOCA were retrospectively analyzed.ResultsAmong the 22 patients(mean age 71±5 years),each of whom had more than one cardiovascular diseases,17 patients(77.3%) were benign AOCA,including separate origin of left anterior descending and left circumflex from left coronary sinus in 9 cases,left circumflex from right coronary sinus in 3 cases,right coronary arteries from ascending aorta in 3 cases,and left circumflex hypoplasia in 2 cases.5 patients(22.7%) had potentially serious AOCA,of which,left main trunk from right coronary sinus in 1 case,right coronary artery from left coronary sinus in 2 cases,and single left coronary artery in 2 cases.During 1～6 years of follow-up,there was no cardiovascular event related to potentially serious AOCA.ConclusionElderly AOCA has no specific clinical manifestation,and which is usually found in coronary angiography.Elderly AOCA doesn't seem to result in significant clinical events.