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Background: Posterior interventricular artery (PIVA), usually a branch of right coronary artery supplies both theventricles and the posterior 1/3rd of the interventricular septum. In some cases, PIVA can also arise from the leftcoronary artery. Origin of posterior interventricular artery determines the cardiac dominance. The present studyis aimed to assess the cardiac dominance by assessing the number, origin and termination of the posteriorinterventricular artery in the human cadaveric hearts. The blood supply of the inferior myocardium depends onthe dominance. Hence the awareness of these variations plays an important role in treating the inferior wallinfarcts.Materials and Methods: This study was carried out in the Department of Anatomy, Sree Mookambika Institute ofMedical Sciences. A total of 112 adult human cadaveric hearts were collected and the parameters such as thenumber, origin and the termination of the posterior interventricular artery were noted.Results and Discussion: In the present study, the PIVA is seen in all the hearts. Out of 112 cases, the right coronarydominance was seen in 94 cases (84%), and left coronary dominance was seen in 18 cases (16%). And the levelof termination of PIVA is more, ie; 42 out of 112 specimens (37.5%) are ½ way down the PIVS.Conclusion: Coronary artery disease is one of the major causes of death in developing countries. The advanceddiagnostic and therapeutic interventional procedures necessitate the sound knowledge of the coronary arterypattern. Prognosis of inferior wall infarcts are related to coronary dominance. So the study of PIVA may behelpful in coronary artery angiography and bypass surgeries.
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Background: Among heart diseases, coronary artery disease is one of the major causes of death in developingcountries. Coronary circulation studied by various methods has demonstrated that there is a huge spectrum ofvariation in the branching pattern of the coronary arteries. Blood supply of the heart is achieved by two coronaryarteries originating from the ascending aorta. In present study we prepare casts of coronary arteries by usingcorrosive cast technique to study the origin, course, termination and branching pattern of right coronary arterywith its variations in human hearts.Materials and Methods: 30 fresh specimens of human hearts which were obtained from the post-mortem room,B.J.Medical College, Ahmedabad. The cannula with cone shaped tip was introduced into both the coronaryarteries through the coronary ostia. The lumen was cleaned and after that prepared resin was instilled incoronary ostia. After 24 hours the heart specimen was immersed in concentrated HCL. 30 casts of coronaryarteries were prepared and observed.Results: In All the specimens the right coronary artery ostium was present in the right anterior aortic sinus.Termination of RCA was found at the crux and beyond crux in 21 specimens (70 %); at the right border in 3specimens (10 %) and at the left border in 5 specimens (16.66 %). right marginal artery terminated at the apex in23 specimens (76.66 %) and near to the apex in 7 specimens (23.33 %). The PIVA arose from the RCA in 27specimens (90 %) and from the LCA in 3 specimens (10 %). In 25 specimens (83.33 %). the sinu-atrial nodal arterywas found to be originating from RCA and in 5 specimens (16.66 %) it originated from the LCADiscussion: Anatomical variations of the coronary arteries are important, as decisions with regard torevascularization procedures in many cardiovascular diseases depend on knowledge of the anatomy of eachindividual artery. Knowledge of the normal and variation in branching pattern of right coronary artery is helpfulto anatomist, radiologist and cardiologist as this is important for the interpretation of coronary angiography,various shunt surgery and stenting procedures.
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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.
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Introduction: Myocardial bridging is the term used when a segment of major epicardial coronary artery runs intramuscularly under the tunnel formed by fibers of myocardium that bridges instead of it’s normal or routine epicardial path. In the literature there are varying reports on clinical implications of myocardial bridges from protection against atherosclerosis to myocardial ischemia, as well as leading to infarction and sudden cardiac death. Materials and Methods: 150 adult formalin fixed human hearts which were available in the department of Anatomy and Forensic Medicine, S.V.Medical College, Tirupati, Andhra Pradesh, India. These hearts were dissected and observed for the presence, location, type, number and direction of myocardial bridges and their association with coronary dominance. With the help of digital calipers morphometric parameters (length, width& thickness) of myocardial bridges and length of blood vessel underneath the myocardial bridge were measured, noted and photographs were taken. Results: The overall incidence of myocardial bridges was 20.6%( 31/150). Among these 18.6% (28/31) were on left anterior descending (LAD) artery and 2% (03/31) were on posterior interventricular (PIV) artery. The direction of muscle fibers in the bridges were oblique to the direction of the coronary vessels in majority of cases. Length, width and thickness of myocardial bridges were in the range of 12-69.7mm, 3.74-8.6mm and 1.3-3.87mm respectively. Conclusions: Myocardial bridges may be associated with wide range of clinical problems. Contraction of myocardial bridge may results in vascular compression and myocardial ischemia. Knowledge on morphology and morphometric details of myocardial bridges facilitates cardiologists in diagnosis, planning therapeutic strategies and prognostic predictions.
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We are performing a study on the distribution of atherosclerosis in the arteries and during our dissectionswe have found arterial malformations in the brain and heart. Of these, 6 are related to the posterior cerebralarteries and 3 are related to the posterior Interventricular artery of the heart. In all these three cases, suchaforementioned abnormality in the circle of Willis also occurred. It is an interesting and unexpected findingand we are still waiting for further development in our work in order to clarify these ârelatedâ malformations.