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目的探讨冠状动脉起源异常(anomalous origin of coronary artery,AOCA)的冠状动脉造影特征及其临床意义。方法2000年10月~2006年12月在我院行冠状动脉造影的患者1560例,检出有AOCA患者29例,并对其临床资料进行回顾性分析。结果29例AOCA患者检出率为1.9%,其中23例(79.3%)为良性AOCA,包括:前降支和回旋支分别开口于左冠窦15例,回旋支起源于右冠窦3例,右冠状动脉起源于无冠窦1例和高位开口于升主动脉4例;6例(20.7%)为有潜在临床危险AOCA,分别为左主干起源于右冠窦1例,单支左冠状动脉2例,右冠状动脉起源于左冠窦3例。起源异常冠状动脉有明显狭窄患者9例(31.0%),但仅2例为狭窄只累及起源异常动脉。结论AOCA无特征性临床表现,通常在冠状动脉造影时被发现;某些类型有导致严重心脏事件的潜在危险。AOCA与冠状动脉狭窄无相关性。
Objective To investigate the coronary angiography features of anomalous origin of coronary artery (AOCA) and its clinical significance. Methods From January 2000 to December 2006, 1560 patients undergoing coronary angiography in our hospital were enrolled. Twenty-nine patients with AOCA were detected and their clinical data were retrospectively analyzed. Results The detection rate of 29 patients with AOCA was 1.9%. Twenty-three of them (79.3%) were benign AOCA, including 15 cases of anterior descending coronary artery and circumflex artery, Right coronary artery originated in 1 case without coronary sinus and in 4 cases high in the ascending aorta. Six cases (20.7%) were potentially clinically dangerous AOCA. The left main coronary artery originated from the right coronary sinus in 1 case and the left coronary artery 2 cases, right coronary artery originated in 3 cases of left coronary sinus. Nine patients (31.0%) had abnormal stenosis of origin coronary artery, but only two patients with stenosis involved the origin abnormal artery. Conclusion AOCA has no characteristic clinical manifestations, usually found during coronary angiography; some types have the potential to cause serious cardiac events. AOCA and coronary artery stenosis no correlation.