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目的探讨成人冠状动脉(冠脉)造影人群先天性冠脉畸形(CCA)的类型及其发生率。方法2000年10月～2006年10月共1520例成人患者行冠脉造影检查,对检出有CCA患者的影像资料进行回顾性分析,并根据CCA解剖学特征进行分类。结果1520例成人患者共检出各类CCA58例,发生率3.82%。冠脉起源和分布异常26例,发生率1.71%;其中前降支和回旋支分别开口于左冠窦14例,左主干或回旋支起源于右冠窦各1例,右冠脉分别起源于升主动脉4例、左冠窦3例和无冠窦1例,单支左冠脉2例。冠脉终止异常11例,均为冠脉瘘,发生率0.72%。冠脉结构异常21例,发生率1.38%,其中心肌桥18例,回旋支发育不良2例,窦房结动脉起源于左室后支1例。本组病例未发现有冠脉间异常交通者。结论冠脉造影是诊断成人CCA的主要方法之一,按解剖学特征进行分类有助于阐明CCA类型及其发生率。
Objective To investigate the types and incidence of congenital coronary artery disease (CCA) in adult coronary artery (coronary artery) angiography. Methods A total of 1520 adult patients underwent coronary angiography from October 2000 to October 2006. The imaging data of patients with CCA were retrospectively analyzed and classified according to the anatomical features of CCA. Results A total of 15 CCA cases were detected in 1520 adult patients, with a prevalence of 3.82%. Coronary origin and distribution of abnormalities in 26 cases, the incidence rate of 1.71%; of which the anterior descending branch and the circumflex artery were opened in the left coronoid sinus in 14 cases, left main or gyrus originated in the right coronary sinus in 1 case, right coronary artery originated in 4 cases of ascending aorta, 3 cases of left coronary sinus, 1 case of non-coronary sinus and 2 cases of left coronary artery. Coronary abnormalities in 11 cases, both coronary fistula, the incidence rate of 0.72%. Coronary structural abnormalities in 21 cases, the incidence rate of 1.38%, including 18 cases of myocardial bridge, malaria dysplasia in 2 cases, sinus node originated in the left ventricular posterior branch in 1 case. This group of patients found no abnormal coronary traffickers. Conclusion Coronary angiography is one of the main methods for the diagnosis of adult CCA. Classification by anatomical features can help clarify the type of CCA and its incidence.