目的：回顾现有的关于冠状动脉旁路移植术（CABG）作为成人冠状动脉异常起源的治疗选择的文献。
方法：在2023年3月进行了系统的文献检索（包括OvidMEDLINE，OvidEmbase,和CochraneLibrary数据库），以确定报告冠状动脉异常起源的成年患者使用CABG的研究。
结果：共纳入31项研究和62例患者，32例患者（52%）为女性，平均年龄为45.1±16.1岁。最常见的冠状动脉异常是26例患者（42％）的左冠状静脉窦引起的右冠状动脉。23例患者（37%）出现了来自肺动脉的左冠状动脉异常。61例患者共使用65个导管，1例病例报告未报告导管类型。报告的移植物包括隐静脉(65个中的23个[35.4%])，左胸廓内动脉（15/65[23.1％]），右胸廓内动脉（65个中的23个[35.4%]），和桡动脉（65个中的2个[3.1％]）；右胃上动脉和贵重静脉各使用一次（1.5％）。42例（67.7％）患者进行了天然冠状动脉结扎术。在19项研究中，患者的随访时间平均为31.2个月。仅报告1例手术死亡。
结论：根据有限的可用数据，CABG可以进行良好的早期结果。使用动脉导管和结扎天然冠状动脉可以改善长期移植物的通畅性。
OBJECTIVE: To
review the available literature on the use of coronary artery bypass grafting (CABG) as a treatment option for anomalous origin of coronary artery in adults.
METHODS: A systematic literature search was performed in March 2023 (including Ovid MEDLINE, Ovid Embase, and the Cochrane Library databases) to identify studies reporting the use of CABG in adult patients with anomalous origin of coronary artery.
RESULTS: A total of 31 studies and 62 patients were included, 32 patients (52%) were women, and the mean age was 45.1±16.1 years. The most common coronary anomaly was the right coronary artery arising from the left coronary sinus in 26 patients (42%), followed by an anomalous left coronary artery from the pulmonary artery in 23 patients (37%). A total of 65 conduits were used in 61 patients, and 1 case report did not report conduit type. Reported grafts included saphenous vein (23 of 65 [35.4%]), left internal thoracic artery (15 of 65 [23.1%]), right internal thoracic artery (23 of 65 [35.4%]), and radial artery (2 of 65 [3.1%]); right gastroepiploic artery and basilic vein were used once (1.5%) each. Ligation of the native coronary artery was performed in 42 (67.7%) patients. Patient follow-up was available in 19 studies with a mean of 31.2 months. Only 1 operative mortality was reported.
CONCLUSIONS: Based on the limited available data, CABG can be performed with good early results. Use of arterial conduits and ligation of the native coronary artery may improve long-term graft patency.
