Origins of the Coronary Arteries and Their Significance

Joshi, S.D.; Joshi, S.S.; Athavale, Sunita Arvind

doi:10.1590/s1807-59322010000100012

Cited by 25 publications

(47 citation statements)

References 25 publications

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“…In present study, the LCA was found to take origin from LPAS in all specimens which support the earlier studies by different authors 3,6,7,9,10,11,12,13,14 .…”

Section: Discussionsupporting

confidence: 92%

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Variations in the Left Coronary Artery

Alam

2017

Chatt Maa Shi Hosp Med Coll J

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Background : There is a large spectrum of variations in the disposition of coronary arteries. Many of these variations are 'normal' and not considered as 'anomalous'1 . These variations mainly occur in the Left Coronary Artery (LCA) 2 . While some of these are benign and have no clinical consequences, other variants can cause important clinical manifestations including sudden death of the individual 3 . Lack of knowledge of such variations can pose difficulties in percuteneous coronary arteriography, coronary artery bypass surgery or prosthetic valve replacement. A cadaveric study in unsuspected population can help to understand the variations that will be useful to determine the prevalence of certain variations. Thus the objective of this study was to analyze the characteristics of LCA that may be used in the diagnosis and treatment of its pathologies. Methods: The study was carried out in the Department of Anatomy, Chittagong Medical College (CMC) Chittagong over a period between Jan 2012 to Dec 2013 with ethical clearance. A detailed dissection of LCA and its branches in 50 cadaveric human hearts, fixed in 10% formalin was carried out to study normal and variant anatomy of LCA. The length of the main stem of LCA was measured by slide calipers. Results: The LCA was found to arise from the Left Posterior Aortic Sinus (LPAS) of the ascending aorta in 100% cases. The level of the ostia (Opening of coronary artery) was above the free margin of the aortic cusps in 98% cases. In all samples ostia were present below sinutubular ridge (A slight circumferential thickening separating bulbar aortic sinus and proximal ascending aorta). The length of the main stem of LCA (From origin to the point of termination into main branches) was found to range from 0.5-2 cm. The LCA showed bifurcation in 74%, trifurcation in 26% of cases. Left Anterior Descending artery (LAD) was found to terminate at the apex of the heart in 68% and at the posterior interventricular groove in 32% cases. The Left Circumflex artery (LCx) was terminated at the crux of the heart in 52%, near the crux in 44% and by crossing the crux in 4% cases. The Left Marginal Artery (LMA) which was present only in 34% cases, found to terminate nearer to the apex of the heart. 0% Left dominance of heart was observed. Conclusion: Simple attention to potential variations in the origin, number, level of ostia, length of the main stem, branching pattern, termination and distribution of LCA can greatly enhance clinical outcomes.

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“…In present study, the LCA was found to take origin from LPAS in all specimens which support the earlier studies by different authors 3,6,7,9,10,11,12,13,14 .…”

Section: Discussionsupporting

confidence: 92%

“…Normally, the coronary ostia are located above the free margins of the aortic cusps within the sinus of Valsalva and below sinutubular ridge 1,5,6 . This location of ostium below sinutubular ridge is important for maximum coronary diastolic filling 7 .…”

Section: Discussionmentioning

confidence: 99%

Variations in the Left Coronary Artery

Alam

2017

Chatt Maa Shi Hosp Med Coll J

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“…Some anomalies of the coronary arteries can also cause sudden death especially in young athletes. 8 Hence t horough knowledge of normal and variant anatomy of coronary arteries is a prerequisite for clinicians to treat congenital, acquired, metabolic or degenerative heart diseases. 3 Present study was conducted in 60 specimens and right coronary dominance was observed in 55 cases (91.7%) which is similar with other studies.…”

Section: Resultsmentioning

confidence: 99%

Study of Posterior Interventricular Artery in Human Cadaveric Hearts

Subramanian¹,

Nanjundaiah²

2017

IJAR

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Back ground: Human heart is supplied by coronary arteries. Variations in the branching pattern of coronary arteries can affect the blood supply to the heart.Context: Origin of posterior interventricular artery determines the coronary dominance. Prognosis of inferior wall infarcts is related to coronary dominance.Purpose: The present study was conducted in 60 specimens of human cadaveric hearts and observed for number, origin, and level of termination of posterior interventricular artery.Results: Present study was conducted in 60 specimens and right coronary dominance was observed in 91.7%. The incidence of left coronary dominance was observed in 6.7% and co-dominance was found in 1.7%. Conclusion:Posterior interventricular artery has special importance as it determines the coronary dominance. The blood supply of the inferior myocardium depends on the dominance. Hence awareness of these variations plays an important role in treating inferior wall infarcts. Also awareness of coronary artery variations is important during interventions like imaging by conventional catheters.

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“…The initial portion of the aortic root, which houses the leaflets of the aortic valve, is occupied by the aortic sinuses, also called the sinuses of Valsalva. [1] The aortic sinuses reach beyond the upper border of the cusp and form a well-defined, complete, and circumferential sinutubular ridge when viewed from the aortic aspect. These sinuses are named according to their position as the anterior, left posterior, and right posterior aortic sinuses.…”

Section: Introductionmentioning

confidence: 99%

“…The recent introduction of selective coronary arteriography that provides an accurate localization of the anatomical variations and underlying pathology, the advances made in coronary arterial bypass graft surgeries and modern methods of myocardial revascularization makes it imperative that a thorough, sound and complete knowledge of the normal and variant anatomy of origin of coronary arteries and their distance in relation with sinutubular ridge is required, which led to this study. [1] …”

Section: Introductionmentioning

confidence: 99%

A cadaveric study on the anatomical variations of origin of the coronary arteries in Gujarat state

Parmar¹,

Soni²,

Khatri³

2017

Int J Med Sci Public Health

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INTRODUCTIONThe coronary arteries arise from the aortic sinuses. The initial portion of the aortic root, which houses the leaflets of the aortic valve, is occupied by the aortic sinuses, also called the sinuses of Valsalva.[1] The aortic sinuses reach beyond the upper border of the cusp and form a well-defined, complete, and circumferential sinutubular ridge when viewed from the aortic aspect. These sinuses are named according to their position as the anterior, left posterior, and right posterior aortic sinuses. The right coronary artery (RCA) arises from the anterior coronary sinus and the left coronary artery (LCA) from the left posterior aortic sinus. In clinical terminology, the anterior, left and right posterior sinuses are often called the right, left, and non-coronary sinuses, respectively. Recently, coronary artery anomalies as a cause of coronary heart disease are gaining consideration in the diagnostic workup. One of the subsets of coronary artery anomalies is the anomalous origin. This subgroup has important clinical manifestations, including sudden death, especially in young athletes. The recent introduction of selective coronary arteriography that provides an accurate localization of the anatomical variations and underlying pathology, the advances made in coronary arterial bypass graft surgeries and modern methods of myocardial Background: A thorough knowledge of the anatomy of coronary arteries, the crown of the heart does a self-evident prerequisite for more intelligent planning of surgery or a complete understand of the coronary artery disease. Abnormal origin of coronary arteries may cause potentially dangerous symptoms and even sudden death during strenuous activity. A cadaveric study in an unsuspected population provides a basis for acknowledgment of normal variants, which may facilitate determination of prevalence and evaluation of the value of screening for such anomalies. Objectives: This study was conducted with an aim to describe the anatomical variation in the origin of right and left coronary arteries (RCA and LCA). Materials and Methods: This study based on the examination of 100 cadaveric hearts from the anatomy dissection room and obtained at an autopsy department. By using conventional dissecting techniques, heart specimens were dissected and studied for number of ostia, and their position within respective sinuses. The heights of the ostia from the bottom of sinuses were measured with the help of Vernier caliper. Results: There was no opening found in pulmonary artery and non-coronary sinus coronary arteries. Single, double and triple ostia were present in 78%, 20%, 2% of cases, respectively. The height of coronary ostia from the bottom of the respective aortic cusp which was measured by digital Vernier caliper depicts that RCA ostium was higher than that of the LCA ostium. Conclusion: The findings in this study may provide a basis for understanding the normal variants, for determining the incidence of anomalies, and for evaluating the value of screening for such anomalies.

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Origins of the Coronary Arteries and Their Significance

Cited by 25 publications

References 25 publications

Variations in the Left Coronary Artery

Variations in the Left Coronary Artery

Study of Posterior Interventricular Artery in Human Cadaveric Hearts

A cadaveric study on the anatomical variations of origin of the coronary arteries in Gujarat state

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