CLINICAL AND APPLIED ANATOMY OF THE LEFT CORONARY ARTERY VARIATION

Abstract

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Background. Coronary arteries play an important role in perfusion of the heart tissues. Variations or anomalies of coronary arteries may be asymptomatic, while some can be symptomatic and may even cause sudden death. Knowledge of coronary artery variations is important in diagnosing and treating cardiovascular diseases. Aim. The aim is to describe variations of the LCA and its branching patterns. Material and Methods. A total of 78 human hearts were dissected, examined and measured using 0.01 mm sensitive digital calipers. Results and Discussion. The mean outer diameter of left coronary artery (LCA), left anterior descending (LAD) and circumflex artery (CA) was 4.34±2.01, 4.21±0.28 and 2.73±0.6 mm respectively. Whereas the mean length of LCA, LAD and CA was 10.2±3.5, 83.4±17.8 and 44.6±17.9 mm respectively. The main trunk of LCA bifurcated in 63 specimens (80.76%), trifurcated in 8 specimens (10.25%), quadrifurcated in 6 specimens (7.69%) and pentafurcated in 1 specimens (1.28%). Variation in the origin of coronary arteries and their branching pattern can pose difficulties in imaging by conventional catheters, and in the management of congenital and acquired heart diseases. Short LCA explains some failures of adequate coronary perfusion from aortic valve surgery, and it is also a risk factor in developing coronary atherosclerosis. In conclusion, the high degree of variability of the LCA and its branching patterns has anatomical, pathophysiological diagnostic and therapeutic implications. Conclusions. Adequate knowledge of these variations is important for the interpretation of coronary angiography, stenting procedures and surgical myocardial revascularization.