冠状动脉异常主动脉起源的研究进展  

Research progress on origin of abnormal aorta in coronary artery

作　　者：叶明棠 王洋 郁迪[1] 戚继荣[1] 莫绪明[1] Ye Mingtang;Wang Yang;Yu Di;Qi Jirong;Mo Xuming(Department of Thoracic and Cardiac Surgery,Children’s Hospital of Nanjing University,Nanjing 210000,China)

机构地区：[1]南京医科大学附属儿童医院心胸外科,南京210000

出　　处：《中华胸心血管外科杂志》2024年第2期117-123,共7页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：冠状动脉异常主动脉起源(anomalous aortic origin of a coronary artery,AAOCA)是一种罕见的先天性心血管畸形,指冠状动脉的起始、走行或分布异常,一般认为是胚胎时期冠状动脉异常发育或未能发育完全造成的,可以不伴随其他先天性心脏病而独立存在。随着医学的发展及人们对AAOCA的认识,越来越多的AAOCA被检出,其临床意义也越来越受关注。基于冠状动脉开口异常、恶性或潜在恶性走行可造成长期血流动力学改变,出现畸形血管段动脉硬化,同时由于走行于肺动脉和升主动脉两血管之间,易受大血管的挤压作用,导致冠状动脉内暂时血流中断,可引起急性心绞痛、心肌梗死、心律失常、运动性心源性晕厥,甚至猝死。本文重点综述冠状动脉异常起源于主动脉的解剖、诊断及治疗方法。Anomalous aortic origin of the coronary artery(AAOCA)refers to the abnormal initiation,route,or distribution of coronary arteries,which is generally believed to be caused by abnormal or incomplete development of embryonic coronary arteries,and is a rare congenital cardiovascular malformation.It can exist independently without other congenital heart disease.With the development of medical science and people's understanding of AAOCA,more and more AAOCA has been detected,and its clinical significance has attracted more and more attention.Based on abnormal coronary artery opening,malignant or potential contorts can cause long-term blood flow dynamic change,appear abnormal blood vessel hardening of the arteries,at the same time due to walk in the pulmonary artery and the ascending aorta between two vessels,vulnerable to the extrusion of large blood vessels,which caused a temporary blood flow in coronary artery interruption,can cause acute angina pectoris,myocardial infarction,arrhythmia,exercise-induced cardiac syncope.This review focuses on the anatomy,diagnosis and treatment of coronary artery abnormalities arising from aorta.

关 键 词：先天性心脏病 冠状动脉异常 心源性晕厥 急性心绞痛 升主动脉 血流动力学改变 胚胎时期 畸形血管 

分 类 号：R541.1[医药卫生—心血管疾病]