THE ANOMALY OF LEFT MAİN CORONARY ARTERY ORİGİNATİNG FROM THE RİGHT CORONARY ARTERY DETECTED BY 64-SLİCE MULTİDETECTOR COMPUTED TOMOGRAPHY

Öz

Coronary artery origin anomalies are usually benign and determines in angiography which made with any causes. Some types of these anomalies which seen rarely can cause serious results. The 43 year old female patient was admitted to the hospital worsing chest pain in the last times. Chest pain was typical, so we planned coronary angiography. In angiography we determined originating the left main coronary artery from right sinus valsalva. In 64-slice multi-detector competed tomographic angiography the left main coronary artery was lying in front of the pulmonary artery. We aimed to emphasize the importance of new imaging modalities in a patient with coronary artery anomallies. 

Anahtar Kelimeler

• Coronary anomaly
• left main coronary artery
• multi-slice computed tomography

SAĞ KORONER ARTERDEN KÖKEN ALAN SOL ANA KORONER ARTERİN 64 KESİTLİ BİLGİSAYARLI TOMOGRAFİ İLE GÖRÜNTÜLENMESİ

Öz

Koroner arter çıkış anomalileri sıklıkla benign bir durum olup herhangi bir nedenle yapılan koroner anjiografi sırasında saptanmaktadır. Nadir olarak görülen bazı tipleri seyirleri dolayısıyla ciddi klinik sonuçlara neden olabilmektedir. Kırk üç yaşında bayan hasta son zamanlarda gittikçe artan efor anginası şikayeti ile başvurdu. Ağrısının tipik karakterde olması nedeniyle yapılan koroner anjiografide sol ana koroner arterin sağ sinüs valsalvadan çıktığı saptandı. Yapılan 64 kesitli bilgisayarlı tomografi (BT) ‘de sol ana koroner arterin pulmoner arterin ön tarafında seyrettiği tespit edildi. Biz koroner arter anomalisi olan bu hastada yeni görüntüleme tekniklerinin önemini vurgulamayı amaçladık.

Anahtar Kelimeler

• Koroner anomali
• sol ana koroner arter
• çok kesitli bilgisayarlı tomografi

Kaynakça

1. Roberts WC. Major anomalies of coronary arterial origin seen in adulthood. Am Heart J. 1986; 111: 941-63.
2. Click RL, Holmes DJ Jr,Vlietstra RE et al. Anomalous coronary arteries: location, degree of atherosclerosis and effect on survival: a report from a coronary artery study. J Am Coll Cardiol. 1989; 13: 531-7.
3. Donaldson RM, Raphael MJ, Yacoub MH et al. Hemodynamically significant anomalies of the coronary arteries: surgical aspects. Thorac Cardiovasc Surg. 1982; 30: 7-13.
4. Yamanaka O, Hobbs RE. Coronary artery anomalies in 126.595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn. 1990; 21: 28-40.
5. Angelini P, Velosco JA, Flamm S. Coronary anomalies: İncidence, pathophysiology and clinical relevance. Circulation 2002; 105: 2449-54.
6. Sheldon WS, Hobbs RE, Millit D, Raghavan PV, Moodie DS. Congenital variations of coronary anatomy. Cleve Clinic Q. 1980; 47: 126-30.
7. Ishikawa T, Brandt PWT. Anomalous origin of the left main coronary artery from the right anterior aortic sinus: angiographic definition of anomalous course. Am J Cardiol. 1985; 55: 770-6.
8. Ropers D, Moshage W, Daniel WG, et al. Visualization of coronary artery anomalies and their anatomic course by contrast-enhanced electron beam tomography and three-dimensional reconstruction. Am J Cardiol. 2001; 87: 193-7.

9. 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.
10. Rigollaud JM, Jimenez M, Vallot M, Laborde N, Latrabe V, Choussat A. Myocardial infarction in a child with an anomalous left coronary artery arising from the right coronary sinus. Arch Mal Coeur Vaiss 2001; 94: 499-503