A Case of Surgical treatment of Coronary Artery Anomaly

Yıl 2014, Cilt: 17 Sayı: 1, 76 - 78, 01.01.2013

Burçin Çayhan Serpil Taş Hakan Saçlı Mehmed Yanartaş Hasan Sunar

https://doi.org/10.4274/khj.4971

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

• Reul RM, Cooley DA, Hallman GL, Reul GJ. Surgical Treatment of Coronary Artery Anomalies Report of a 37½-Year Experience at the Texas Heart Institute. Tex Heart Inst J 2002;29:299-307. Koroner Anomali
• Koşuyolu Heart Journal 2014;17(1):76-78
• Kim SY, Seo JB, Do KH, Heo JN, Lee JS, Song JW, et al. Coronary ArteryAnomalies: Classification and ECG-gated Multi-Detector Row CT Findings with Angiographic Correlation. Radiographics 2006;26:317-33; discussion 333-4.
• Safi AM, Rachko M, Tang A, Ketosugbo A, Kwan T, Afflu E. Anomalous origin of the left main coronary artery from the right sinus of Valsalva disabling angina and syncope with noninteratrial courses case report of two patients. Heart Dis 2001;3:24-7.
• Greenberg MA, Fish BN, Spindola-Franco H. Congenital anomalies of the coronary arteries. Classification and significance. Radiol Clin North Am 1989;27:1127-46.
• Matherne GP. Congenital anomalies of the coronary vessels and the aortic root.In: Allen HD, Gutgesell HP, Clark EB, Driscoll DJ. Heart disease in infants, children, and adolescents. Philadelphia: Lippincott Williams & Wilkins.2001;676-7.
• İyisoy A, Kurşaklıoğlu H, Barçın C, Köz C, Demirtaş E. Sağ Sinüs Valsalva‘dan Çıkan Sol Ana Koroner Arter. T Klin J Cardiol 2003;16:107-9.
• Basso C, Maron BJ, Corrado D, Thiene G. Clinical profile of congenital coronary artery anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol 2000;35:1493-501.
• Romano S, Morra A, Del Borrello M, Greco P, Daliento L. Multi-slice computed tomography and the detection of anomalies of coronary arteries. J Cardiovasc Med (Hagerstown) 2008;9:187-94.