Anatomic Parameters of the Left Coronary Artery: an Angiographic Study in a South African Population

Abstract

SUMMARY: An understanding of the left coronary artery (LCA) anatomy is important for accurate diagnosis and therapeutic intervention in the management of coronary arterial diseases. This angiographic study aims to document the parameters of the LCA that may be of importance in the diagnosis and treatment of coronary artery diseases. An analysis of 151 coronary angiograms obtained from the cardiac catheterization laboratory in the eThekwini Municipality area of KwaZulu-Natal, South Africa was performed. The mean length and diameter of the LCA were 10.4±4.1 mm (range 2.8-23.9 mm) and 3.8±0.8 mm (range 2.1-6.5 mm), respectively. The mean angle of division between the two main branches was 86.2°±26.1° (range 27°-68.5°). There was a positive correlation between the length and the angle of division of the LCA, with the longest LCAs having the largest angle of division. The branching patterns of the LCA were 80.8%, 18.5% and 0.7% for bifurcation, trifurcation and quadrifurcation, respectively. Coronary arterial dominance was 81.5%, 15.2%, and 3.3% for right, left, and co-dominance, respectively. This study corroborated earlier findings that the longer the length, the wider the angle of LCA division. A wide angle of LCA division, the shape and disposition of the proximal tract of LCA branches may affect flow, interfere with proper deployment of stents or may predispose to earlier atherosclerotic lesions.

Morphologic Relationship Between the Coronary Arteries During Fetal Development

“…Quadrifurcation of the LCA (Type C) was recorded in 2.4 % of the specimens and was similar to the reports of Ajayi et al (2013) (0.7 %), Santhoshkumar et al (2 %) and Jaishree et al (4 %). The incidence of Type C was however lower than that of Kalpana, Ogeng'o et al and Beg et al, and who recorded 11 %, 9.6 % and 10 %, respectively (Table III).…”

“…LCA Type B (trifurcation), occurred in 29.3 % and was similar to Dattatray et al (35.9 %), Ajayi et al (2013) (18.5 %), Tomar et al (24 %),Ogeng'o et al (32.2 %) and Santhoshkumar et al (26 %). This differed from the results of Kulkarni & Mehta (2012) and Jaishree et al (2015) who found 11.54 % and 14.5 %, respectively (Table III).…”

“…J. Morphol., 35(4):1197-1202, 2017 The size of the coronary arteries typically determines the treatment options in the management of coronary artery disease as small arteries may cause anastomotic difficulties during bypass grafting and can influence the outcome in procedures such as stenting and balloon angioplasty (Ajayi et al, 2013).…”

“…The median artery can originate from the vertex of the angle between the AIB and CX arteries including the proximal part of the AIB and CX arteries (Ajayi et al, 2013;Chougule et al). From the literature reviewed, there is paucity of reports on the anatomic relationship of the development of the RCA and the LCA in fetuses.…”

Prevalence of Third Coronary Artery: Variation or Constant Coronary Artery?

“…These findings suggest ethnic variability and appear to support the suggestion by Garg et al (2000) in some individuals. About 10 % of clinical malpractice is due to the ignorance of the anatomical variations (Ajayi et al, 2013). The size of the coronary arteries typically determines the treatment options in the management of coronary artery disease as small arteries may cause anastomotic difficulties during bypass grafting and can influence the outcome in procedures such as stenting and balloon angioplasty.…”