Os ramos ventriculares posteriores das artérias coronárias no homem

Abstract

468The clinical application of the anatomical study of the ventricular branches of coronary arteries is the execution and interpretation of examination methods and the planning and performing of cardiovascular disease treatment [1][2][3][4][5][6] . In 1940, Schlesinger 1 developed the anatomical concept of balance or predominance in coronary artery circulation in the diaphragmatic face of the heart, using the crux cordis region as a reference. The crux cordis is defined as the point where the coronary sulcus meets the interatrial and interventricular sulci. According to the author 1 , the right coronary artery was predominant when it provided the posterior interventricular branch and supplied blood for most of the left ventricular posterior wall. However, this criterion did not quantify the limit of this region in the posterior wall. In the balanced type, the right coronary artery irrigated only the right ventricle and the posterior part of the interventricular septum, and did not provide significant branches for the left ventricle, which was irrigated by the left coronary artery. The criterion remained subjective, because it did not define the concept of significant branches, because, for example, in left dominance, the left coronary artery provided, along with the right coronary artery, parallel posterior interventricular branches, or only the left coronary artery provided a posterior interventricular branch, sometimes sending branches to the right ventricle.Blunk and DiDio 7 considered dominance of the right coronary artery to be all cases in which the right coronary artery provided branches for the posterior face of the right ventricle. More recent studies by Falci Junior et al 8 reported that in right dominance, the right coronary artery reached and extended beyond the crux cordis, providing 1 or more branches to the left ventricle; in balanced circulation, the right coronary artery reached that point, but did not extend beyond it; and, in left dominance, the left coronary artery reached the crux cordis, originating, or not, branches to the right ventricle. For this reason, they did not consider the possibility that the branches extending beyond the crux cordis were of little significance.In addition, these classifications did not consider the fact that sometimes the anterior interventricular branch surrounded the apex of the heart and extended upward in the posterior interventricular sulcus, which, according to Cavalcanti et al 9 occurred in 28.18% of the cases, and according to Lima Júnior et al 10 in 50%. Therefore, we found it pertinent to include the analysis of the anterior interventricular branch among our classification criteria.Pino et al 6 reported a division of the ventricles between the coronary sulcus and the apex of the heart into superior, middle, and inferior thirds. However, we believe that the addition of 1 ObjectiveTo describe the trajectory of the posterior ventricular branches of the coronary arteries in the epicardial adipose tissue, and to propose a new criterion for analyzing the di...

Left and right coronary artery blood flow distribution method based on dominant type

“…73.33% of enrolled patients showed right dominance, 18.97% were balanced and only 7.69% of patients showed left dominance. These proportions are similar to values given in the literatures 24–26 …”

“…73.33% of the cohort were RD, 18.98% were BD, and 7.69% LD. Proportions of BD and LD were found to be significantly less than RD, which is consistent with the results of previous studies 5, [24][25][26] (Figure 3).…”

“…To generate the 3D model of the coronary artery, the vessel wall was assumed to be rigid 23 and blood was given the material properties of being an adiabatic, isotropic and incompressible Newtonian fluid. Blood flow was unsteady laminar flow, blood density was 1050 kg/m 3 and the hemodynamic viscosity was set to 0.0035 Pa s 3,24 …”

“…These proportions are similar to values given in the literatures. [24][25][26] The coronary artery is responsible for supplying blood to the heart, reflecting the supply-demand relationship with the myocardium, represented by the following equation:…”