中国介入心脏病学杂志2024,Vol.32Issue(2) :112-115.DOI:10.3969/j.issn.1004-8812.2024.02.009

冠状动脉介入治疗罕见异常起源的左回旋支急性闭塞1例

One case of coronary intervention treatment for acute occlusion of the left circumflex artery with rare abnormal origin

李涛 程振业 李学香 张俊杰 王鑫 张伟
中国介入心脏病学杂志2024,Vol.32Issue(2) :112-115.DOI:10.3969/j.issn.1004-8812.2024.02.009

冠状动脉介入治疗罕见异常起源的左回旋支急性闭塞1例

One case of coronary intervention treatment for acute occlusion of the left circumflex artery with rare abnormal origin

李涛 1程振业 1李学香 1张俊杰 2王鑫 2张伟2
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作者信息

  • 1. 莱州市人民医院心血管内科,山东莱州 261400
  • 2. 莱州市人民医院急诊内科,山东莱州 261400
  • 折叠

摘要

冠状动脉异常起源是心血管疾病中罕见的临床表现.其中,左回旋支的异常起源占全部冠状动脉造影患者的0.022%~0.024%.而左回旋支异常起源合并急性闭塞的病例则更为罕见.术中及时制订有效的寻找异常开口的策略和方法对完成介入治疗非常重要.本病例报道1例冠状动脉介入治疗罕见左回旋支异常起源于无冠窦且左回旋支急性闭塞导致心肌梗死.患者突发胸痛入院,心电图提示下壁、后壁ST段抬高.急行冠状动脉造影示仅见左主干及左前降支、右冠状动脉(心肌梗死溶栓治疗试验血流分级Ⅲ级),而未见左回旋支.左右冠窦内均未发现左回旋支.于升主动脉根部非选择造影,最后于无冠窦内发现开口异常的左回旋支.本病例针对异常起源左回旋支常见部位、寻找异常开口的策略、方法及介入治疗等方面进行讨论.

Abstract

Abnormal origin of coronary artery is a rare clinical manifestation in cardiovascular disease,among which the abnormal origin of left circumflex artery accounts for 0.022%-0.024%of all coronary angiography patients.Cases of abnormal origin of the left circumflex artery combined with acute occlusion are even rarer.Timely and effective strategies and methods for finding abnormal openings during surgery are crucial for completing interventional treatment.This case reports a rare left circumflex artery anomaly originating from the absence of coronary sinus and acute occlusion of the left circumflex artery leading to myocardial infarction during coronary intervention treatment.The patient experienced sudden chest pain and was admitted to the hospital.The electrocardiogram showed elevated ST segments in the lower and posterior walls.The acute coronary angiography showed only the left main trunk,left anterior descending branch,and right coronary artery(thrombolysis in myocardial infarction blood flow grade Ⅲ),but no left circumflex branch No left circumflex branch was found in the left and right coronary sinuses.Non selective angiography was performed at the root of the ascending aorta,and an abnormal opening of the left circumflex branch was finally discovered in the non coronal sinus.This case discusses common sites of abnormal origin of the left circumflex branch,strategies,methods,and interventional treatments for finding abnormal openings.

关键词

左回旋支异常起源/无冠窦/急性心肌梗死

Key words

Abnormal origin of left circumflex branch/Non coronary sinus/Acute myocardial infarction

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出版年

2024
中国介入心脏病学杂志
北京大学

中国介入心脏病学杂志

CSTPCDCSCD
影响因子:1.224
ISSN:1004-8812
参考文献量16
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