Angiographical Studies on the Distribution of Coronary Arteries in Children | Part 2. Caliber and Distribution of Coronary Arteries in Congenital Heart Disease

Abstract

In order to determine the normal size of various branches of the coronary arteries and to clarify the etiological factors that determine the dominant patterns of coronary arteries (dominance) and the relationship between the growth of the coronary arteries and the ventricles, the caliber and the distribution of major coronary arterial branches were measured by selective coronary arteriography in 41 cases with normal hearts and 49 cases with congential heart disease. In normal hearts, the incidences of right dominant(R), balanced(B) and left dominant(L) types were 78%, 15% adn 7%, respectively. In congenital heart disease, the incidences of R, B and L types in right ventricular loading hearts (RV group) were 94%, 0% and 6%, respectively and those in left ventricular loading hearts (LV group) were 58%, 27% and 15%, respectively. The ratios of left main trunk and proximal right corornary in size (LMT/RCA ratio) in RV group weremuch smaller and LMT/RCA ratios in RV group were much larger than those in normal hearts. these results indicated that in the different types of heart anomalies the loading of pressure and volume to the ventricles varies in grade, and subsequently induced the hypertrophy of the loaded parts. It was thought that the resultant hypertrophy also affected the growth and dominance of the coronary arteries.