학술논문
Secondary coronary artery ostial lesions: Three case reports.
Document Type
Report
Author
Liu XP; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Wang HJ; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Gao JL; Laboratory of Molecular Medicine, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Ma GL; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Xu XY; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Ji LN; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; He RX; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Qi BY; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Wang LC; Department of Radiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Li CQ; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Zhang YJ; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China.; Feng YB; Department of Cardiology, Ordos Clinical College of Inner Mongolia Medical University, Ordos Central Hospital, Ordos 017000, Inner Mongolia Autonomous Region, China. xnkfyb@sina.com.
Source
Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 101618806 Publication Model: Print Cited Medium: Print ISSN: 2307-8960 (Print) Linking ISSN: 23078960 NLM ISO Abbreviation: World J Clin Cases Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2307-8960
Abstract
Background: Atherosclerosis is one of the main causes of coronary artery ostial lesions seen clinically. Secondary coronary artery ostial lesions are rare, and cases reported previously were associated with syphilitic vasculitis and aortic dissection. Here, we report three rare cases of secondary coronary ostial lesions. Due to their rareness, these lesions can easily be neglected, which may lead to misdiagnosis and missed diagnosis.
Case Summary: We present three patients with acute myocardial infarction and unstable angina caused by secondary coronary artery ostial lesions. In Case 1, coronary angiography (CAG) revealed 90% stenosis of the left main coronary ostium. Chest contrast computed tomography (CT) suggested thymic carcinoma invading the left main coronary ostium. Coronary artery bypass grafting and tumor resection were performed. In Case 2, echocardiography revealed a sinus of Valsalva aneurysm (SVA)-like dilatation. CAG showed a right coronary sinus giant aneurysm and complete obstruction of the right coronary artery (RCA) ostium. Aortic contrast CT confirmed these findings. The Bentall procedure was performed. In Case 3, CT CAG identified an anomalous origin of the right coronary artery (AORCA) from the left sinus of Valsalva coursing between the aorta and pulmonary trunk, causing severe RCA ostium stenosis by compression. Surgical correction of the AORCA was performed.
Conclusion: The cases reported here suggest that we should consider other causes of coronary ostial lesions other than atherosclerosis.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest.
(©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Case Summary: We present three patients with acute myocardial infarction and unstable angina caused by secondary coronary artery ostial lesions. In Case 1, coronary angiography (CAG) revealed 90% stenosis of the left main coronary ostium. Chest contrast computed tomography (CT) suggested thymic carcinoma invading the left main coronary ostium. Coronary artery bypass grafting and tumor resection were performed. In Case 2, echocardiography revealed a sinus of Valsalva aneurysm (SVA)-like dilatation. CAG showed a right coronary sinus giant aneurysm and complete obstruction of the right coronary artery (RCA) ostium. Aortic contrast CT confirmed these findings. The Bentall procedure was performed. In Case 3, CT CAG identified an anomalous origin of the right coronary artery (AORCA) from the left sinus of Valsalva coursing between the aorta and pulmonary trunk, causing severe RCA ostium stenosis by compression. Surgical correction of the AORCA was performed.
Conclusion: The cases reported here suggest that we should consider other causes of coronary ostial lesions other than atherosclerosis.
Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest.
(©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)