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目的探讨经胸超声心动图(TTE)诊断冠状动脉起源异常(CAOA)的临床应用价值。方法应用TTE对11例CAOA患者进行检查,显示冠状动脉的起源、走行、血流方向、性质、时相和速度,观察有无合并其他心血管畸形,并与冠状动脉造影和手术结果比较。结果左冠状动脉起源于肺动脉5例、起源于右冠状动脉1例,左前降支起源于右冠状动脉1例,疑诊左前降支或左回旋支起源于右冠状动脉窦1例,左前降支和左回旋支单独起源于左冠状动脉窦2例,右冠状动脉高位发出1例。其中合并右冠状动脉-右室瘘1例,卵圆孔未闭1例,二尖瓣前叶夹层动脉瘤形成伴破裂1例,继发性心内膜弹力纤维增生症3例。超声结果与冠状动脉造影和手术结果符合。结论经胸超声心动图能准确提供冠状动脉的起源、走行、血流状态等信息,具有重要的临床应用价值。
Objective To investigate the clinical value of transthoracic echocardiography (TTE) in diagnosis of coronary artery disease (CAOA). Methods Eleven patients with CAOA were examined by TTE. The origin, course, flow direction, nature, time and velocity of coronary artery were observed. TTE was compared with other coronary angiography findings and coronary angiography findings. Results The left coronary artery originated from pulmonary artery in 5 cases, originated in the right coronary artery in 1 case, left anterior descending artery originated in the right coronary artery in 1 case, suspected left anterior descending artery or left circumflex artery originated in 1 case of right coronary artery, left anterior descending artery And left circumflex artery originated in the left coronary artery in 2 cases, right coronary high in 1 case. One case of right coronary artery - right ventricular fistula, patent foramen ovale in 1 case, anterior mitral aneurysm rupture in 1 case, 3 cases of secondary endocardial fibroelastosis. Ultrasound results consistent with coronary angiography and surgical findings. Conclusion Transthoracic echocardiography can accurately provide information on coronary artery origin, travel, blood flow status and other important clinical applications.