右冠状动脉起源于左前降支一例

患者男性 ,62岁。因冠心病心绞痛入院 ,冠状动脉造影发现右冠状动脉起源于左前降支中段 ,它是一种罕见的左单支冠状动脉畸形。具有潜在的危险性     

右冠状动脉起源于左前降支中段致心绞痛发作1例

<正>患者：男性,47岁,主因发作性胸痛2个月,加重10余天入院。体格检查：血压119/74 mmHg(1 mmHg=0.133 kPa),肺部、腹部未见明显异常。既往体格健康,有吸烟史约20年,每天约60支。2021年9月入院查心电图提示窦性心律,V4～6导联ST段压低约0.1 mV。心肌酶正常,低密度脂蛋白3.25 mmol/L。心脏彩色超声（彩超）示：左室舒张末内径4.7 cm,左室射血分数59%。入院前10 d,外院冠状动脉增强CT示：冠状动脉硬化,左冠状动脉为著,其中左冠状动脉前降支近、中段,回旋支管腔重度狭窄,右冠状动脉起源于左冠状动脉前降支近段（起源异常）。     

右冠状动脉起源于左乏氏窦伴左前降支冠脉肌桥

右冠状动脉起源于左乏氏窦是较少见的冠脉畸形,在一组１２６５９５例连续冠脉造影病人中占１３６例（０．１１％）［ＹａｍａｎａｋａＯ,ＨｏｂｂｓＲＥ：ＣａｔｈＣａｒｄｉｏｖａｓＤｉａｇ,１９９０,２１：２８～４０．］,既往多认为其属良性病变,无重要临床意义。然而,近年来渐有发生心肌梗塞、心绞痛、晕厥、猝死等的报道。目前认为其属潜在恶性异常。本文报告１例临床具有胸痛与心电图异常而冠脉造影无局灶病变患者,临床资料如下。患者男性,４１岁,以“发作性心前区疼痛６天”为主诉入院,患者于行走时突发胸痛,向左背部放…     

左冠状动脉异位窦起源致猝死1例

<正>左冠状动脉异位窦起源(anomalous origins of the left coronary artery from the opposite sinus of Valsalva,ALCAOS)是属于冠状动脉异常起源于主动脉的一种先天性冠状动脉病变,其解剖特征是左冠状动脉开口位置(通常起源右冠窦)及走行异常,异常冠状动脉走行于主动脉、肺动脉之间,且异常段冠状动脉多在主动脉壁内走行。此种畸形既是心源性猝死的最重要原因之一,也是青少年运动后晕厥甚至死亡的主要     

左冠状动脉异常起源于右冠状动脉窦一例

1 临床资料 患者男性,12 岁,因"反复晕厥 3 年,胸痛伴晕厥 1 次"入院.患者 3 年前起反复发作晕厥,发作前于运动中突发头晕、黑矇,随即晕厥,每次持续约 10～20 min,曾行心肺复苏后苏醒,醒后感胸前区发紧、疼痛,约 5 min 后缓解.既往多次就诊于外院,未查明病因.患者于运动中再发晕厥,症状同前,就诊...     

左冠状动脉前降支自发性夹层介入治疗1例

自发性冠状动脉夹层（SCAD）是一种罕见的冠状动脉病变,严重时可导致急性心肌梗死甚至猝死。尽管目前已提出了一些原因,如避孕药物的使用、先天性结缔组织发育不良综合征、马凡综合征以及结节性多动脉炎等[1-3],但真正的原因尚不清楚,且与冠心病危险因素并无重叠[1,4]。     

左主干起源于右冠状动脉窦一例

患者 ,男 ,4 1岁 ,反复发作性胸痛、胸闷 2年 ,加重 1周 ,于 2 0 0 1年 5月入院。 2年前在骑车时出现心前区疼痛伴胸闷、憋气、出汗 ,休息 3～ 4ｍｉｎ后症状自行缓解。每年发作 5～ 6次 ,发作时查心电图示窦性心动过缓 ,但无ＳＴ Ｔ改变 ,拟诊“冠心病” ,口服硝酸异山梨酯等治疗。入院前一周类似症状发作 3次。既往有高血压病史 5年 ,服降压 0号等治疗 ,血压控制良好。高血脂 4年 ,间断服用微粒化非诺贝特。吸烟 5年 ,15支 /ｄ。入院查体 :血压 16 0 /110ｍｍＨｇ(1ｍｍＨｇ =0 133ｋＰａ) ,心脏不大 ,心率 6 6次 /ｍｉｎ ,律齐 ,无病理…     

儿童左冠状动脉起源右冠状窦合并运动后心肌梗死、泵衰竭1例

本文报道浙江大学医学院附属金华医院2019年9月25日收治的1例患儿,运动后诱发心肌损伤、心源性休克、泵衰竭,接受呼吸机、体外膜氧合器支持治疗。冠状动脉(下称冠脉)计算机断层扫描血管成像和冠脉造影显示左冠脉起源右冠状窦,行左冠脉起源异常矫治术治疗。术后随访,该患儿进行性心脏扩大、左心室收缩功能减退,临床预后差。     

前降支介入治疗术中右冠状动脉顽固性痉挛1例

<正>病例资料:患者女性,69岁,因反复心绞痛药物治疗无效,于2012年9月26日入院。有高血压病史20余年,无糖尿病,血脂正常。入院后第三天行冠状动脉造影示:左主干开口狭窄40%,前降支近中段弥散性狭窄,最重处狭窄95%,第一对角支开口狭窄80%,右冠状动脉呈弥散性不规则病变(图1)。根据造影结果,决定介入干预前降支。前降支介入治疗过程:选择右股动脉入路,穿刺成功后,置入6F动脉鞘,肝素9 000U鞘入,选用6F Judkins指引导管,经指引导管送入两根BMW指引导丝,其中一根置于第一对角支保护,另一根通     

A single coronary artery from the right sinus of valsalva associated with atherosclerosis

Anomalous origin of the main coronary arteries from the aorta is rare. We report a case with a single coronary artery from the right sinus of Valsalva associated with atherosclerosis.The patient was treated with a coronary artery bypass procedure: left internal mammary artery (LIMA) to the left anterior descending artery (LAD), right internal mammary artery (RIMA) to the right coronary artery (RCA).The postoperative course was uneventful.     

A case of anomalous origin of circumflex artery from right sinus of valsalva recognized by transesophageal echocardiography]

A 56-year-old man visited our hospital for further examination of resting electrocardiographic abnormality. Positive exercise stress resulted in mild chest discomfort and 1.5 mm ST depression in II.III.aVF leads. Myocardial imaging perfusion with thallium-201 was normal and an anomalous origin of the left circumflex coronary artery from the right aortic sinus was observed by coronary angiography. MRI showed that the vessel running behind the aorta was connected to the right Valsalva's sinus. Furthermore, transesophageal echocardiography revealed that the vessel connected to the lateral wall of the left ventricle was running from the right Valsalva's sinus between the aorta and left atrium. The above results indicated that this vessel was the left circumflex artery. Although myocardial infarction or sudden death in patients with coronary anomaly has been discussed, the mechanism is still unknown. The present case is a rare one in which the anatomical relation between the anomalous coronary and the great vessels was directly detectable by transesophageal echocardiography. Transesophageal echocardiography is useful for the assessment of this type of coronary anomaly.     

Anomalous origin of the left coronary artery from the right sinus of valsalva

We present the clinical, angiographic and surgical findings in a 63-year-old man with anomalous origin of the left main coronary artery from the right sinus of valsalva. The course of the left main artery was abnormal in that it passed between the aorta and the pulmonary artery; in addition, there was obstructive disease involving the left main coronary artery. The association of these two entities in this age group is unusual.     

Asymptomatic ruptured sinus of valsalva aneurysm into the right ventricle

A 32-year-old man, admitted for inguinal hernia repair, wasreferred for preoperative     

Ruptured left sinus of valsalva aneurysm to right atrium

A 6-year-old child presented with left sinus of Valsalva aneurysm opening in right atrium. Origin of sinus of Valsalva from left aortic sinus and its opening into right atrium is extremely rare. The anomaly was corrected surgically by patch closure at the aortic end. Follow-up echocardiography did not reveal any residual shunt in right atrium.     

Rupture of a right sinus of valsalva aneurysm into the right ventricle during vaginal delivery: a case report

A case is reported of a right sinus of Valsalva aneurysm rupture into the right ventricle during vaginal delivery in a 34-year-old healthy woman in her third pregnancy. Pregnancy was carried to term and a healthy baby was delivered vaginally. On day 7 following vaginal delivery she was admitted to hospital for dyspnea and cough, with clinical signs of severe heart failure. The diagnosis of the right sinus of Valsalva aneurysm rupture into the right ventricle was established by transthoracic and transesophageal echocardiography. Clinical recognition and early echocardiographic diagnosis followed by immediate surgical repair proved lifesaving in our patient.     

Anomalous origin of coronary arteries from three separate ostia in the right sinus of valsalva. A case port and review of the literature

The authors report the case of a patient undergoing coronary angiography for a lateral myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from separate ostia in the right sinus of Valsalva. Anomalous origin of coronary arteries from the opposite sinus are potentially serious especially among young subjects and when a vessel runs between the aorta and pulmonary artery. Clinical presentation, angiographic diagnostic and treatment strategies are discussed.