A Case of Surgical treatment of Coronary Artery Anomaly

Öz

Coronary artery anomalies may present as anomalies of origination, course and termination (eg.A-V fistula), and as coronary artery aneurysms. Coronary artery anomalies are rare entities, and are usually detected during angiograms or necropsy. The rate of congenital coronary artery anomalies is reported to be between 0.3% and 1.3% in adult patients underwent invasive coronary angiograpies and 1% in routine autopsy studies. Of them 87% were anomalies of origin and course and 13% were coronary artery fistulas. Although most of the cases with coronary artery anomalies were asymptomatic, ectopic origin and course of coronary artery between aorta and pulmonary artery were reported to be associated with myocardial ischemia and sudden cardiac death.We present a case who had left main coronary artery arising from the right sinus of Valsalva, which is a rare congenital anomaly; and we reviewed the literature.

Anahtar Kelimeler

• Coronary artery anomaly, coronary artery bypass; congenital anomaly

Koroner Arter Anomalili Bir Olguda Cerrahi Tedavi

Öz

Koroner arter anomalileri; çıkış anomalileri, seyir anomalileri, sonlanma anomalileri (A-V fistül), koroner arter anevrizmaları şeklinde olabilir. Koroner arter anomalisi, nadir görülen bir durum olup, daha çok anjiyografi veya otopsi sırasında tespit edilmektedir. İnvaziv koroner anjiyografi yapılan erişkin hastalarda konjenital koroner arter anomalisi sıklığı %0,3-%1,3 arasında iken, rutin olarak yapılan otopsi incelemelerinde %1 olarak saptanmıştır. Bunların %87'si çıkış ve dağılım anomalisi iken, %13'ü koroner arter fistülleridir. Koroner arter anomalisi saptanan olguların çoğunluğu asemptomatik olmasına rağmen, ektopik orijinli ve aort-pulmoner arter arasında seyirli sol koroner arter gibi anomalilerde miyokard iskemisi ve ani ölümle sonuçlanan olgular da bildirilmiştir.Bu yazımızda, nadir görülen bir anomali olan sol ana koroner arterin sağ sinüs valsalvadan çıktığı bir olgu sunulmuş ve literatür incelenmiştir.

Anahtar Kelimeler

• Koroner arter anomalisi, koroner arter bypass; konjenital anomali

Kaynakça

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