冠状动脉的异常大动脉起源
Elizabeth H Stephens1, Anusha Jegatheeswaran2, Julie A Brothers3
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota.
The Annals of thoracic surgery
|February 1, 2024
概括
冠状动脉的异常大动脉起源 (AAOCA) 存在各种风险,包括突然心脏骤停 (SCA). 对AAOCA的管理决策需要仔细考虑缺血证据和患者症状,并进行持续的研究以完善风险分层和外科指导.
科学领域:
- 心血管外科心血管外科
- 儿童心脏病学 儿童心脏病学
- 医疗成像医学成像
背景情况:
- 冠状动脉的异常大动脉起源 (AAOCA) 与突然心脏骤停 (SCA) 风险有关.
- 全方位的AAOCA疾病和最佳管理策略需要进一步澄清.
- 越来越多的证据需要对AAOCA管理进行更新的视角.
研究的目的:
- 审查关于冠状动脉异常大动脉起源 (AAOCA) 的当前文献.
- 提供关于AAOCA管理的最新观点.
- 讨论与AAOCA和当前手术干预相关的风险.
主要方法:
- 进行了全面的文献审查.
- 从2010年到现在的出版物在PubMed.com上进行了调查.
- 一个由先天性心脏外科医生,心脏病专家和成像专家组成的小组审查了这些文献.
主要成果:
- AAOCA的流行率在0.4%至0.8%之间.
- 异常左冠状动脉较为罕见,但比异常右冠状动脉具有更高的SCA风险.
- 手术干预决策涉及解剖特征,缺血症证据和症状;缺血症测试准确性仍然存在挑战.
结论:
- 一些患有AAOCA的患者由于缺血需要手术干预.
- 需要进一步的研究来提高可诱导性缺血的检测和AAOCA患者的风险分层.
- 需要改进的指导来确定哪些AAOCA患者需要进行外科手术.
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