Individual variability of vascularization of the anterior papillary muscle within the right ventricle of human heart

Abstract

BackgroundTo date there is scarce published evidence reporting the dual blood supply reaching anterior papillary muscle (APM), which descends from both major coronary arteries. Such a vascular configuration can prevent the dysfunction of right ventricular entire valvular system in case of the occlusion of proximal part of either right coronary artery (RCA) or left coronary artery (LCA). The aim of our study was to determine the vascular pattern of APM blood supply which originates from two main coronary arteries, in the context of the APM and septomarginal trabecula (SMT) topography.MethodsThe study was carried out using tissue obtained from 36 human hearts. The material was divided into four morphological types of SMT/APM arrangement. Vascularization and blood supply pattern of papillary muscle was investigated following the analysis of multiple tissue cross sections. The origin of APM arterial supply was traced back to both main coronary arteries. Cross-sectional area of the arteries was estimated at the base of APM and compared within mixed male-female population, aged 18–76.ResultsWe noted that as much as 78% of entire APM material had a blood supply vasculature originating from both LCA and RCA branches. In contrast, 22% of cases APM was supplied by a single coronary artery, while in each case it proved to be LCA. We have never found APM arterial supply provided exclusively by RCA. In case of double AMP blood supply an average of total cross-section area of the arteries branching from LCA, was noted to be in excess of two and a half times bigger in type III and more than two times bigger in type IV, as compared with the arteries originating from RCA.ConclusionsOur research confirm the possibility of double blood supply which vascularizes APM, but the finding does not necessarily apply in all cases. However, APM seems to be predominantly vascularized by arteries deriving from LCA, regardless of their morphological type.

Topologic and Hemodynamic Characteristics of the Human Coronary Arterial Circulation

“…Available anatomical studies address specific research questions and provide only limited data that do not allow a translation toward global coronary hemodynamics. This includes the vascularization of the anterior papillary muscle, perfused by the LCA versus RCA (Zajaczkowski et al, 2018), the impact of branching on wave propagation (Rivolo et al, 2016), the effect of side branches on coronary flow (Wiwatanapataphee et al, 2012), and branching patterns of only the large coronary arteries (Hutchins et al, 1976;Seiler et al, 1992;van der Waal et al, 2009;Schoenenberger et al, 2012;Cardenes et al, 2013;Gupta et al, 2013;Medrano-Gracia et al, 2017;Ormiston et al, 2018). In an initial study, we analyzed the presence of collateral connections within and between the perfusion territories in the human heart .…”

Cadaveric Study on the Morphology and Morphometry of Heart Papillary Muscles

“…The left ventricular wall is almost three times thicker than the right one. Due to its lower mass, the right ventricle has lesser oxygen demand compared to the left ventricle [ 16 ].…”