Coronary artery anatomy and variants

Abstract

Variants and congenital anomalies of the coronary arteries are usually asymptomatic, but may present with severe chest pain or cardiac arrest. The introduction of multidetector CT coronary angiography (MDCT-CA) allows the detection of significant coronary artery stenosis. Improved performance with isotropic spatial resolution and higher temporal resolution provides a valid alternative to conventional coronary angiography (CCA) in many patients. MDCT-CA is now considered the ideal tool for three-dimensional visualization of the complex and tortuous anatomy of the coronary arteries. With multiplanar and volume-rendered reconstructions, MDCT-CA may even outperform CCA in determining the relative position of vessels, thus providing a better view of the coronary vascular anatomy. The purpose of this review is to describe the normal anatomy of the coronary arteries and their main variants based on MDCT-CA with appropriate reconstructions.

MDCT of Congenital Coronary Artery Fistulas

“…However, MRA has a long acquisition time, generally lower spatial resolution for clinical acquisitions, and a contrast-to-noise ratio inferior to that of CT [15,28] (Table 3). MRA can be useful for assessing the proximal coronary arteries, but assessment of the distal coronaries remains challenging [29,30]. MRA is further restricted for patients with claustrophobia, pacemakers, surgical clips, arrhythmia, and tachycardia [8,15].…”

“Two for One”, Novel Dual Left Anterior Descending Artery (LAD) Variant: Type XIII

“…Typically, the LMCA gives rise to the LAD artery, which descends through the epicardial fat of the AIS. It then proceeds to give off septal and diagonal branches which supply the anteroseptal and anteroapical regions of the heart [1]. Dual LAD describes a rare anatomic variant in which two coronary branches, known as the "short" and "long" LAD arteries, supply the territory normally supplied by the solitary LAD artery.…”

“…Dual left anterior descending artery (LAD) is a rare phenomenon that occurs in less than one percent of the population [1]. To date, 12 variants have been identified [2].…”

The relaxing effect ofPoncirus fructusand its flavonoid content on porcine coronary artery

“…Both vessels rest in the epicardial fat. The left and right coronary arteries are branched into four principal sections: the right coronary artery, left main coronary artery, left anterior descending artery, and left circumflex artery [ 23 ]. The vessels supply oxygen-rich blood to the heart muscles; therefore, inappropriate dilation in these vessels can result in angina pectoris or myocardial infarction [ 24 ].…”