DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181274

Variations in the anatomical and branching pattern of the left coronary artery: a cadaveric study

Lakshmiprabha S., Khizer Hussain Afroze, Ramesh P., Asha K. R., Shivaleela C., Anupama D.

Abstract


Background: Coronary arteries are the branch of ascending aorta and it is the main arterial supply of the myocardium of the heart. Left coronary artery (LCA) usually arises from left posterior aortic sinus. The site of manifestation of myocardial infarction depends on the occlusion of an artery or its branches involved in atherosclerosis. To know the site of lesion and occlusion of the particular artery, detailed anatomy of its course, branches and variations to be studied in detail.

Methods: Study was conducted on 55 heart specimens in Department of Anatomy at Sri Siddhartha Medical College (SSMC), Sri Siddhartha Academy of Higher Education (SSAHE). The left coronary artery was dissected carefully, and it was traced from its origin. Any variation in the course and branching pattern was recorded and photographed.

Results: No variation was found in the origin of LCA. In the present study, the most frequent division pattern of the left coronary artery was observed as the bifurcation in 30 specimens (54.54%) followed by trifurcation in 23 specimens (41.82%). Tetrafurcation and pentafurcation of LCA were observed in one specimen each (1.82%).

Conclusions: Our study tries to focus on branching pattern of LCA for the better knowledge of accurate diagnosis and therapeutic intervention in the management of coronary artery diseases.


Keywords


Anomalies, Coronary arteries, Heart vessels

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References


Standring S. Gray’s Anatomy. The Anatomical Basis of clinical Practice. 40th Ed. New York: Chrchill Livingstone;2008:995-1027.

Baptista CA, DiDio LJ, Prates JC. Types of division of the left coronary artery and the ramus diagonalis of the human heart. Japan Heart J. 1991;32(3):323-35.

Kalpana R. A study on principal branches of coronary arteries in humans. J Anat Soc Ind. 2003;52(2):137-40.

Surucu HS, Karahan ST, Tanyeli E. Branching pattern of the left coronary artery and an important branch. The median artery. Saudi Med J. 2004;25(2):177-81.

Reig J, Petit M. Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest. Clinical Anatomy. 2004;17(1):6-13.

Ballesteros LE, Ramirez LM. Morphological expression of the left coronary artery: a direct anatomical study. Folia Morphologica. 2008;67(2):135-42.

Bhimalli S, Dixit D, Siddibhavi M, Shirol VS. A study of variations in coronary arterial system in cadaveric human heart. World J Sci Technol. 2011;1(5):30-5.

Udhayakumar S, Yasawardene SG. A preliminary study on anatomy of the main trunk of left coronary artery of Sri Lankans. Proc Jaffina Univ Int Res Conf. 2012;3:1327-30.

Agnihotri G, Kaur M, Kalyan GS. Branching pattern of left coronary artery among north Indians. Anat J Afr. 2013;2:145-50.

Dharmendra P, Takkalapalli A, Madan S, Londhe P. Clinical significant anatomical variation of left coronary artery in human cadaveric hearts. Int J Curr Res Rev. 2013;05(12):39-43.

Ogeng’o JA, Misiani MK, Olabu BA, Waisiko BM, Murunga A. Variant termination of the left coronary artery: Pentafurcation is not uncommon. Eur J Anat. 2014;18(2):98-101.

Beg MR, Singh A, Goel S, Goel AK, Goel V, Goyal P, Surana A, Singh NK, Dhanda MS. Anatomical variations of coronary artery and frequency of median artery: A cadaveric study from Northern India. Int Arch Integr Med. 2015;2(5):88-91.

Patel JP, Desai JN, Bhojak NR. A cadaveric study of variation in branching pattern of left coronary artery. J Anat Soci Ind. 2016;65(2):101-3.

Mallashetty N, Itagi V. The study of branching pattern and variations in the left coronary artery in human heart with a unique case of crossing of coronary arteries- A cadaveric study. Ind J Clin Anatomy Physiol. 2017;4(1):48-50.

Ravi V, Tejesh S. Anatomical variation in branching pattern and dominance in coronary arteries: A cadaveric study. Int J Anat Res. 2017;5(1):3611-17.

Sekhri T, Kanwar RS, Wilfred R, Chugh P, Chhillar M, Aggarwal R, et al. Prevalence of risk factors for coronary artery disease in an urban Ind population. BMJ Open. 2014;4:e005346.

Bhutto MG, Lokesh MR, Shah SKD, Afroze M.K.H, Ghouse P, Abhilash D. Association between lipid profile and silent coronary artery disease in South Indian patients with type 2 Diabetes mellitus. Inter J Advan Med. 2017;4(1):6-9.

Bosco GA. Diagnóstico anátomo-topográfico de la obstrucción arterial coronaria. Buenos Aires. Artes Gráficas Modernas. 1935:27-30.

Siri AM. Study of branching pattern and distribution of coronary arteries in adult human heart (Doctoral dissertation, RGUHS), 2008.

Spindola-Franco H, Grose R, Solomon N. Dual left anterior descending coronary artery: angiographic description of important variants and surgical implications. American Heart J. 1983;105(3):445-55.

Das H, Das G, Das DC, Talukdar K. A study of coronary dominance in the population of Assam. J Anat Soc Ind. 2010;59 (2):187-91.

Anbumani TL, Christus D, Selvi TA. An anatomical study on the coronary arteries and their variations. Int J Anat Res. 2016;4(1):2114.

Elliott GE. Congenital absence of the right coronary artery with a unique origin of the artery to the sinu-atrial node: A case study. Inter J Anatom Variations. 2012;5(1).