ABSTRACT
Background: Knowledge of the normal and variant anatomy and anomalies of coronary circulation is an increasingly vital component in the management of congenital and acquired heart disease. Anatomical variations in relation to coronary artery and its branches will help cardiac surgeons for refining imaging techniques and coronary artery bypass grafting. The current study is aimed at understanding the normal patterns of coronary arteries with reference to its predominance, branching pattern, variations and anomalies. Methods: Heart specimen for this study were obtained from Department of Anatomy, SIMS Hapur and GFIMSR Ballabhgarh. The cadaveric human hearts were dissected to observe the coronary arteries and its branches. Results: The diameter of right and left coronary orifices were measured. The distance of the orifices from the supravalvular ridge was also measured. The length and the diameter of the coronary arteries and its branches were measured and statistical significance was determined. Conclusion: The present study revealed that, ostium diameter of left coronary artery is larger than the right coronary artery. The outer diameter of the left coronary artery is larger than the right coronary artery. The mean lumen circumference of left coronary artery, anterior interventricular artery, right coronary artery and circumflex artery is more in males as compared to female. This knowledge is important for interpretation of the coronary angiography and surgical myocardial revascularization and paramount to cardiac surgeons for proper diagnosis and treatment of cardiac ailments and radiologists to refine image interpretation.
ABSTRACT
BACKGROUND: Coronary angioplasty and stent implantation is effective as primary intervention in acute myocardial infarction. Because of fewer puncture site complications and improved patient comfort, transradial access has been increasingly used as an alternative to transfemoral access for percutaneous coronary interventions. METHODS AND RESULTS: We studied 103 patients (94 men, 9 women: mean age 52.5 +/- 11.96 years) with a diagnosis of acute myocardial infarction (<12 hours after onset), who underwent primary percutaneous coronary intervention. Transradial access was used in all patients with a normal Allen's test and transfemoral access was used additionally only if intra-aortic balloon counterpulsation was required. Follow-up duration was 6 months. Transradial access was successfully achieved in all patients. Radial artery cannulation took <2 min in more than 85% patients. During percutaneous coronary intervention, cannulation to balloon inflation times and total procedure times were 11.3 +/- 5.2 min and 19.9 +/- 10.8 min, respectively. Stents were implanted in 99 (96.1%) patients andplain balloon angioplastywas performed in 3.9%. The primary success rate was 98.1%, with no major bleeding complications. Total length of hospitalization averaged 2.4 +/- 0.8 days. In-hospital major adverse clinical events rate was 5.9%. Six-month clinical follow-up was achieved for 84 (86.6%) patients. Six (7.1%) patients died during follow-up. Follow-up coronary angiography was performed in 22 (26.2%) patients. After 6 months, 7 patients required revascularizationof the target lesion. The rate of survival without myocardial infarction, bypass surgery or repeat coronary angioplasty was 88.5% at 6 months. CONCLUSIONS: Transradial access may represent a safe and feasible technique for performing primary percutaneous coronary intervention with good acute results and without major bleeding complications.