Improved definition of anomalous left coronary artery by magnetic resonance coronary angiography.
Improved definition of anomalous left coronary artery by magnetic resonance coronary angiography.
复制标题
通过磁共振冠状动脉造影改善异常左冠状动脉的清晰度。
DOI：
10.1016/0002-8703(95)90374-7
复制
发表时间：
1995
影响因子：
4.8
通讯作者：
Edelman,RR
中科院分区：
文献类型：
--
作者：
Manning,WJ;Li,W;Cohen,SI;Johnson,RG;Edelman,RR
先天性冠状动脉异常是罕见的，仅发生在0.6%至1.2%的成人冠状动脉造影13，并经常与其他形式的先天性心脏异常。大多数冠状动脉异常与心肌灌注受损无关。血流动力学显著异常伴心肌灌注异常4包括左冠状动脉起源于肺动脉、先天性冠状动脉狭窄或闭锁、冠状动脉瘘和左冠状动脉起源于右瓦尔萨尔瓦窦，随后血管通过主动脉和右心室漏斗之间。后一种情况被认为是良性的，直到Cheitlin等人5对33名患者中的9名突然死亡的尸检观察，其中左冠状动脉从右Valsalva窦上升。猝死的原因尚不清楚，但已被假设为包括冠状动脉压迫，异常，狭缝状开口，或异常血管的急性起飞角。5虽然通过血管造影术很容易诊断异常冠状动脉，但这些血管的后续行程（右心室流出道的前部或后部）的定义通常很困难。[6]这些信息很重要，因为后向病程与预后不良有关。磁共振冠状动脉造影（MRCA），能够
Congenital coronary artery anomalies are rare, occurring in only 0.6% to 1.2% of adults referred for coronary angiography 13 and frequently in association with other forms of congenital cardiac abnormalities. The majority of coronary anomalies are not associated with impaired myocardial perfusion. Hemodynamically significant anomalies with abnormalities of myocardial perfusion 4 include origin of the left coronary artery from the pulmonary artery, congenital coronary artery stenosis or atresia, coronary artery fistulae, and origin of the left coronary artery from the right sinus of Valsalva with subsequent passage of the vessel between the aorta and right ventricular infundibulum. The latter condition was thought to be benign until the postmortem observations of Cheitlin et al. 5 of the sudden death of 9 of 33 patients in whom the left coronary artery rose from the right sinus of Valsalva. The cause of sudden death is not known but has been hypothesized to include coronary artery compression, an abnormal, slitlike ostium, or acute take-off angles of the anomalous vessel. 5 Although the diagnosis of anomalous coronary arteries is easily made by angiography, definition of the subsequent course of these vessels (anterior or posterior to the right ventricular outflow trac0 is often difficult. 6 Such information is important because a posteriorly directed course is associated with a poor prognosis. Magnetic resonance coronary angiography (MRCA), with the ability