ABSTRACT
Background: Cardiovascular disease is one of the leading causes of morbidity and mortality in the world. Theaim of this study is to observe the branching pattern of left coronary artery with special attention to the originand termination of the posterior interventricular artery(PIVA), to determine the coronary dominance and theoccurrence of myocardial bridges over the anterior interventricular artery(AIVA). Myocardial bridging is acongenital anomalous condition in which a coronary artery takes a “tunneled” course under a “bridge” ofoverlying myocardium. The vessel is compressed in systole, resulting in angina, myocardial ischemia, acutecoronary syndrome, left ventricular dysfunction, sudden cardiac death and arrhythmias.Materials and Methods: This study was taken up at the Institute of Anatomy, Madurai Medical College with 60heart specimens collected from the cadavers of the same Institute and from the Department of Forensic Medicine.The heart specimens of different age groups, sex and socioeconomic status were preserved in 10% formalin andstudied by the conventional dissection method.Results: Among the 60 heart specimens studied, left coronary artery was seen bifurcating in 62%, trifurcating in32% and quadfurcating in 6%. Regarding dominance, right dominance with PIVA arising from right coronaryartery was seen in 53 specimens (88.3%), left dominance with PIVA being the continuation of left circumflexartery(LCX) was seen in 5 specimens(8.3%) and PIVA was arising from both coronaries in 2 specimens(3.4%).Among the 5 left dominant specimens, PIVA was seen as a continuation of LCX artery in 4 and single whereas in1 specimen the PIVA was seen to be double. With regard to termination of PIVA, it terminated in the middle ofposterior interventricular sulcus(PIVS) in 2 specimens and at the junction of anterior 1/3 and posterior 2/3 ofPIVS in the rest. Myocardial bridges were seen over anterior interventricular artery in 15 specimens (25%).Conclusion: Right dominance is seen in majority of hearts followed by left dominance and the balanced patternbeing the least. Presence of myocardial bridges was predominantly seen over AIVA.
ABSTRACT
During the performance of an angiotecnich in a human heart, to highlight the coronary circulation, weobserved the presence of myocardial bridges in the anterior and medial branches of the left coronary artery, inthis heart was also demonstrated the presence of an artery trifurcation left coronary branches that originatedthe anterior interventricular, circumflex and median. Myocardial bridges are intriguing entities that do notalways show signs and symptoms, the presence of the median artery in hearts with myocardial bridges, is oneof the factors that may explain the absence of signs and symptoms in some patients with this entity. Moreoverthe myocardial bridges can explain the signs and symptoms of ischemia on functional testing.
Subject(s)
Humans , Coronary Artery Bypass , Coronary Circulation , Coronary Vessel AnomaliesABSTRACT
@#Objective To evaluate the clinical value of Multi-slice Spiral CT(MSCT) and coronary artery imaging in diagnosing coronary artery myocardial bridges (MBs). Methods Image data of 285 patients from July 2005 to July 2008 who accepted both the MSCT and coronary angiography CAG at our hospital were collected. Diagnostic performance of the two Methods were analysed and the diagnostic accuracy were compared. Results In 285 cases of patients with MSCT examinations, 82 coronary artery were diagnosed in 59 cases, the detection rate of which was 20.7%. In contrast, 16 cases were diagnosed by CAG and the detection rate was 5.6%. In the 82 coronary artery diagnosed by MSCT, 42 coronary artery were single vessel, the proportion was 71.19%. Others were two vessels or three vessels. There were 67 in left anterior descending artery (LAD),in which 52 were near the middle and 15 were distal. 26 MBs diagnosed by MSCT were included in the 28 MBs diagnosed by CAG. Put CAG as the gold standard of myocardial bridge detecting, then MSCT's sensitivity was 92.86%. Conclusion MSCT coronary artery imaging can accurately show the anatomical relationship between coronary artery and myocardial and it is one of the preferred method of diagnosing coronary artery.
ABSTRACT
Objective To determine the pattern and incidence of congenital coronary anomalies (CCA) in adults undergoing coronary angiography. Methods The diagnostic angiographic data collected from October 2000 to October 2006 were reviewed, from which congenital coronary anomalies were found, and their angiographic features were studied. Results Among 1520 adults undergone coronary angiography, anomalous coronary arteries were found in 58 cases (3.82%). Depending on the anatomic characteristics of anomalous coronary arteries, these 58 cases were classified as following. Anomalies of origin and distribution were found in 26 cases (1.71%), among them separated origin of left anterior descending and left circumflex from left coronary sinus were found in 14 cases, left main trunk and left circumflex arising from right coronary sinus in 1 case for each, single left coronary artery in 2 cases, right coronary arteries arising from ascending aorta in 4 cases, from left coronary sinus in 3 cases, and from posterior coronary sinus in 1 case, respectively. Anomalies of coronary termination were observed in 11 cases (0.72%), and all of them were coronary artery fistulas. Anomalies of intrinsic coronary arterial anatomy in 21 cases (1.38%), among them myocardial bridge in 18 cases, hypoplasia of left circumflex artery in 2 cases, and sinus node artery arising from left posterior ventricular branch in 1 case. No anomalous collateral vessels were found. Conclusion Coronary angiography is one of the important methods of detecting anomalous coronary arteries. Classification based on the anatomic characteristics can help clarify the pattern and incidence of congenital anomalies of coronary arteries in adalts.