Hyper-dominant left anterior descending coronary artery with continuation as a posterior descending artery—An extended empire

Jariwala, Pankaj; Kumar, Edla Arjun Padma

doi:10.1016/j.jsha.2018.02.003

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…An AIVA that continues as IIVA has been frequently observed in some studies (Kalbfleisch & Hort, 1976;Ozturk et al, 2011;Perlmutt et al, 1983), but is regarded a rare coronary anomaly by others (Jariwala & Kumar, 2018). In acute coronary syndrome its presence may be fatal as it may lead to infarction of a large area of myocardium.…”

Section: Discussionmentioning

confidence: 94%

“…It was absent in only 14% of hearts studied (Dodge Jr et al, 1988, 1992. In more recent case reports an AIVA that continues as an IIVA in the inferior interventricular groove is considered a rare variant and is termed hyper-or superdominant (Jariwala & Kumar, 2018;Javangula & Kaul, 2007;Shaikh et al, 2018;Varga et al, 2020). In extreme cases, the hyperdominant AIVA runs in the inferior interventricular groove up to the crux of the heart and gives off a left ventricular branch to the inferior surface of the left ventricle (Javangula & Kaul, 2007;Varga et al, 2020).…”

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confidence: 99%

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Variants of arterial supply to the inferior (diaphragmatic) surface of the ventricles of the heart and the influence on age at death

et al. 2022

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Coronary artery systems of the inferior wall of the ventricles vary considerably.Schlesinger's concept distinguishes dominance of the right or left coronary artery (LCA) or balanced type. LCA dominance has been reported to be associated with increased mortality. Early angiography studies have shown that the anterior interventricular artery (AIVA), a branch of the LCA, often continues on the inferior surface of the heart and may replace the inferior interventricular artery. Others considered an AIVA on the inferior surface of the heart a rare variant. A long AIVA is a strong predictor of death in acute anterior wall myocardial infarction. We determined coronary artery variance at the inferior surface of the ventricles in 134 dissected human hearts and analyzed a possible association between coronary artery variance and age at death. The AIVA extended to the inferior side in 64.9% of the hearts, but rarely reached the basal half of the inferior interventricular groove. Most frequently (53%), it extended into the apical two-fifths of the length of the inferior ventricular walls.An AIVA extending to the apical 40% of the length of the inferior ventricular walls may therefore be considered a common variant. In 20.1% of the hearts, a right inferior diagonal artery was also found. Statistical analysis neither revealed an association between mean AIVA length at the inferior ventricular surface and type of coronary artery dominance nor an association between AIVA length at the inferior ventricular surface or coronary artery dominance type and age at death.

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Section: Discussionmentioning

confidence: 94%

mentioning

confidence: 99%

Variants of arterial supply to the inferior (diaphragmatic) surface of the ventricles of the heart and the influence on age at death

et al. 2022

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“…Early appropriate intervention can be lifesaving. 6 The take-home message from this interesting article is that in ACS, when there are STE changes in 2 coronary territories, along with conspicuous absence of reciprocal ST depression, one should analyze the angiograms carefully for the presence of a wraparound or superdominant LAD.…”

Section: Superdominant Lad/hyperdominant (Type-iv)mentioning

confidence: 99%

ECG Prediction of Culprit Lesion in STEMI can Be a Real Challenge, at Times!

Patnaik

2021

Indian Journal of Clinical Cardiology

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“…In an article, Jariwala et al had mentioned nineteen reports of the hyper-dominant LAD artery until 2018. 3 Coronary anatomy need to be defined as it is essential to intervene the diseased artery during ischemia and sometimes anatomical variation too can have angina like presentations. In approximately 85% of people the coronary circulation is right dominant with the posterior descending artery (PDA) arising from the right coronary artery (RCA).…”

Section: Introductionmentioning

confidence: 99%

Hyper-dominant Left Anterior Descending Artery in the coronary circulation as a rare coronary anomaly

Pandey,

Karki,

Pandey

et al. 2023

Nepalese Heart J.

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Hyper-dominant left anterior descending artery is rarely seen in the coronary distribution. Its involvement in ACS can often be detrimental as it supplies most of the anterior and inferior part of the right and left ventricles in compared to other variants of LAD artery. It is required to be recognized earlier and management strategies should be ascertained. Our report here describes such a case of anomalous coronary artery which is less commonly encountered during Coronary Angiography. This was case of a 60 year old hypertensive male who presented with atypical chest pain had normal ECG, echocardiography and cardiac biomarkers but TMT was positive, subsequent Coronary angiographic evaluation came up with LAD artery which was going beyond apex in the posterior interventricular groove up to crux forming PDA with 20 to 30% stenosis in proximal to distal part. Such a large LAD running into the interventricular groove forming PDA is known as “Hyper-dominant” LAD artery. The Right Coronary artery was non-dominant. Fortunately, there was no signifcant coronary artery disease to explain the cause of his chest pain, but the artery had unusual distribution provided that it has sole territorial supply to larger part of the myocardium which can worsen the clinical status if coronary artery disease progresses. He was kept under medical management and was doing good. The “Take away” lesson is that there are very few subjects with Hyper-dominant LAD artery till date and most other cases with this anatomy had presented with myocardial infarction and thus such anatomical variant of LAD artery ought to be matter of concern and further research in the feld of cardiology.

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Hyper-dominant left anterior descending coronary artery with continuation as a posterior descending artery—An extended empire

Cited by 11 publications

References 13 publications

Variants of arterial supply to the inferior (diaphragmatic) surface of the ventricles of the heart and the influence on age at death

Variants of arterial supply to the inferior (diaphragmatic) surface of the ventricles of the heart and the influence on age at death

ECG Prediction of Culprit Lesion in STEMI can Be a Real Challenge, at Times!

Hyper-dominant Left Anterior Descending Artery in the coronary circulation as a rare coronary anomaly

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