Branching of Main Trunk of Left Coronary Artery and Importance of Her Diagonal Branch in Cases of Coronary Insuficiency

Almira Lujinović,Fehim Ovčina,Alma Voljevica,Aida Hasanović

doi:10.17305/bjbms.2005.3274

Almira Lujinović, Fehim Ovčina + Show 2 more

Open Access

https://doi.org/10.17305/bjbms.2005.3274

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Abstract

Proficiency in the anatomy of coronary arteries and their variations is significant for proper interpretation of the coronary angiographies, assessment of the complexity and result of the coronary insufficiency as well as surgical myocardium revascularization. The objective of this study is anatomy-radiology research of the methods of branching the main trunk of left coronary artery and to prove importance of the diagonal branch (ramus diagonalis) existence in the conditions of coronary insufficiency. In this study we have analyzed 100 coronary angiographies done at the Clinic for Heart Diseases and Rheumatism of the Clinic Center of University of Sarajevo and dissected 20 human hearts from the Institute of Anatomy. In our study we have come upon two methods of branching of main trunk of left coronary artery (bifurcation and trifurcation). By the method of the angiography we have found the bifurcation in 71% of cases while 65% of cases were proved by the dissection method. Trifurcation has been discovered in 29% of cases of analyzed angiographies i.e. 35% of cases of dissected hearts. We believe that third terminal branch of the left coronary artery should be marked as ramus diagonalis. This branch, including its anastomoses, presents important pattern of the collateral blood flow, which has special meaning, under conditions of coronary insufficiency.

Highlights

Human heart in the most cases possess right and left coronary artery (a. coronaria dextra et a. coronaria sinistra), and in certain number of cases ( ) there are supernumerary heart arteries
As the left coronary artery, quite often we find variations in the source, in the course and method of branching than it is the case of right coronary artery ( )
James ( ) emphasis that left coronary artery in most of cases is divided on two branches, and rarely there is bigger number of terminal branches

Summary

Introduction

Human heart in the most cases possess right and left coronary artery (a. coronaria dextra et a. coronaria sinistra), and in certain number of cases ( ) there are supernumerary heart arteries. A.coronaria dextra originates from the right aorta sinus (sinus Valsavae dexter), headed from top toward frontal part and externally and emerges at the frontal part of heart. It passes through coronary groove and arrives at the back part of heart, where in the most cases ends at its back interventricularis groove (sulcus interventricularis posterior). Some hearts have the main trunk of left coronary artery containing three terminal branches Left coronary artery might have four or more terminal branches but medium branches are having shorter flow than in case of trifurcation of the main trunk ( ). Proficiency in anatomy of coronary arteries and their variations is significant for proper interpretation of the coronary angiographies, assessment of the complexity and result of the coronary insufficiency as well as surgical myocardium revascularization ( )

Discussion

Conclusions