Background: Ramus intermedius artery is one of the branches of epicardial coronary artery. It shares in supplying the lateral wall of left ventricle. It is regarded as normal anatomical variant that creates appearance of trifurcation of left coronary artery. The atherosclerotic changes in this artery lead to peculiar clinical signs even when other main coronary arteries are preserved and at this time it requires either percutanous coronary intervention or cardiac bypass surgery. Objectives: To know the incidence of ramus intermedius artery among people in Basrah and the significance of its occurrence in interpretation of coronary angiography and surgical revascularization of myocardium. Patients and Methods: This is a prospective study of coronary angiography carried out in Basra cardiac center at Al-Sadder Teaching Hospital. A sample of 110 patients with normal coronary arteries were also recruited. Results: In the present study the sample size was 110 cases; male patients were 61.8% and the female patients were 38.2%; the age of patients were ranged from 35 to 79 years (52 ± 4.1 years). The ramus intermedius artery was present in 30% of cases; the incidence of ramus intermedius artery in male was 33.8%, female 23.8% while the incidence of this artery in people who live in urban area was 35.7%, rural area 24.1%. The length of ramus intermedius artery was variable (mean 59.40±5.48mm); in male 53.6 ± 2.6 mm, female 61.8 ± 3.15 mm and the caliber of this artery (mean 2.13±2.41mm) in male was 1.52 ± 1.01mm, female 2.39 ± 0.24 mm. Conclusions: The ramus intermedius artery would be of great significance in coronary angiographical and surgical interventional findings in patients with this anatomical variant.
Splitting right coronary artery is a benign entity but the atherosclerotic changes once occurred the patient presented with acute coronary disease and even death. It is a very rare coronary artery anomaly and discover incidentally during cardiac angiography or autopsy. Here the pathological and clinical scenarios of this anomaly should be taken in account : Arrhythmia , heamodynamic and cardiac surgery procedures. Aim of study: To know the incidence of splitting or double right coronary artery among people in Basra by conventional coronary angiography. Patients and Methods: Prospective study of coronary angiography carried out in Basra cardiac center at Al-Sadder teaching hospital. A sample of 150 patients attended to cardiac center with acute coronary disease. Results : In our study the incidence of double right coronary artery was 3.3% and the mean length of anterior right coronary artery was 81.43 ± 2.22 mm and the caliber of this artery was 2.96 ± 0.76 mm while the mean length of posterior right coronary artery was 105.33 ± 3.36 mm and its caliber was 3.03 ± 0.732 mm. Conclusion : Double right coronary artery is a benign coronary artery anomaly but it may be life threatened if it associated with other congenital heart anomalies , atherosclerosis, arrhythmias or myocardial infarction.
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