Terminal branching pattern of the right coronary artery in left-dominant hearts: a cadaveric study

Gupta, Tulika; Saini, Abhimanyu; Sahni, Daisy

doi:10.1016/j.carpath.2012.08.001

Cited by 11 publications

(11 citation statements)

References 11 publications

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“…Of the total of 45 hearts used as a material for this work, 37 (77.8%) had the right type of arterial vascularization, which confirmed the results of numerous authors that this type is dominant in human heart vascularization (31)(32)(33). The variation in the frequency of this dominant type of arterial vascularization of the heart may be related to the ethnic diversity of the inestigated populations, ranging from 60.5% to the Pakistani (34), to 86.6% in Turkish (35), up to 89% in the Indian population (36).…”

Section: Discussionsupporting

confidence: 86%

Correlation between the Type of Arterial Vascularizacion and Presence and Localization of Myocardial Bridges

Lujinovic¹,

Cosovic²,

Kapur³

et al. 2018

IJCRR

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Introduction: Myocardial bridges represent an anomaly of the coronary arteries' flow, which can be asymptomatic, or can lead to the coronary insufficiency and its clinical consequences. The aim of this research was to derermine whether there is a correlation between the type of arterial vascularization and presence and localization of the myocardial bridges. Material and Methods: As a material for this work, we used 45 human heart specimens from the Institute of Anatomy of the Medical Faculty in Sarajevo. At each heart, the type of arterial vascularization was determined, and in those specimens with myocardial bridges, the branch on which they were localized was recorded. Results: Out of total 45 human hearts, myocardial bridges were present at 24 (53.3%). One myocardial bridge was present in 16 hearts, two in 7 hearts and three in one heart. In the heart group with myocardial bridges, the incidence of right type of vascularization was 79.2%, and in the group without myocardial bridges 76.2%. The left type of vascularisation was least represented in both groups, with 9.5% in the heart group without bridges and 8.3% in the group with myocardial bridges present. Out of 33 detected myocardial bridges, 25 of them were on the left and 8 on the right coronary artery, so myocardial bridges are much more often localized on the branches of the left than the right coronary arteries, regardless of the type of arterial vascularization. Conclusion: There is no correlation of the type of arterial vascularization of the human hearts with the presence and localization of myocardial bridges.

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Section: Discussionsupporting

confidence: 86%

Correlation between the Type of Arterial Vascularizacion and Presence and Localization of Myocardial Bridges

Lujinovic¹,

Cosovic²,

Kapur³

et al. 2018

IJCRR

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“…Overall, they noticed that in the majority of the hearts with left dominant circulation (60%), the blood supply to the posterior surface of the right ventricle was found to be sparse. 15 This finding may help explain the effect of left dominancy on survival and exercise test.…”

Section: Discussionmentioning

confidence: 91%

Accuracy of exercise tolerance test in the diagnosis of coronary artery disease in patients with left dominant coronary circulation

Attar

Mehrzadeh

Foulad

et al. 2017

Indian Heart Journal

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BackgroundExercise is a physiologic stress that helps the physicians to clarify the presence or absence of cardiovascular disease which may be obscure at rest. Although it is sensitive, its specificity is affected by several parameters, such as some metabolic conditions, some structural heart diseases, and some baseline electrocardiogram abnormalities. Currently, the relationship between coronary dominance and accuracy of EET is not examined. Therefore, this study was conducted to determine the potential impact of coronary dominance on the accuracy of EET.MethodsIn this retrospective study, data were gathered from 720 patients from four medical centers. The pattern of dominancy was determined, and the coronary dominance pattern of the patients who had normal angiograms despite abnormal EETs was compared to that from all the patients.ResultsAmong the patients who had a normal angiogram despite an abnormal EET, 27% were left dominant while the frequency of left dominancy in the whole population of the study was only 10.9% (P = 0.013). There were no significant differences in baseline characteristics, such as age and sex, between the two studied groups.ConclusionThe results indicated that the presence of left dominance in patients who had normal angiograms despite an abnormal EET was significantly higher than general population. Therefore, left dominance may be considered a confounding factor for EET, producing false positive results.

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“…RCA dominant, indicating the posterior-descending branch from the RCA, is the most popular coronary anatomy [6,7]. Coronary artery distribution was categorised as RCA dominant in 48-90% of the cases, left coronary artery dominant in 12.5-22% of the cases and balanced type (defined by the posterior-descending branch arising from both the right and left coronary artery) in 12-34% of the cases [7].…”

Section: Discussionmentioning

confidence: 99%

Current mechanisms of low graft flow and conduit choice for the right coronary artery based on the severity of native coronary stenosis and myocardial flow demand

Nakajima

Takazawa

Yoshitake

et al. 2019

Gen Thorac Cardiovasc Surg

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Objectives We investigated current mechanisms causing low graft flow (LGF) following coronary artery bypass grafting, particularly for the right coronary artery (RCA). Methods We retrospectively assessed 230 individual bypass grafts as the sole bypass graft for the RCA using preoperative and postoperative quantitative angiography. Overall, 155 in-situ gastroepiploic arteries (GEAs) and 75 saphenous vein grafts (SVGs) were included. The size and status of the revascularised area were examined to determine whether these factors were associated with LGF (defined as ≤ 20 mL/min with intraoperative flowmetry). A distal lesion was defined as stenosis at segment #4, whereas a proximal lesion was stenosis at #1, #2 and #3. Results Graft flow in the SVG and the GEA for distal lesion was significantly less compared with that for proximal lesion (34 ± 26 vs. 60 ± 46, p < 0.0001 and 22 ± 12 vs. 43 ± 28, p = 0.0004, respectively). For proximal lesion, LGF was significantly more frequent when the minimal luminal diameter was over 1.27 compared with when it was less than 1.27 (p = 0.02). Prior myocardial infarction significantly correlated with LGF in the GEA (p = 0.007) and the SVG (p = 0.03). In 55 bypass grafts with LGF, the causes were competitive flow in 20.0%, small revascularised area in 38.1% and prior myocardial infarction in 32.7%. Conclusions Along with the current strategy based on the severity of native coronary stenosis, the incidence of competitive flow decreased remarkably. This resulted in flow demand, myocardial status and collateral vessels more influential on graft patency.

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Terminal branching pattern of the right coronary artery in left-dominant hearts: a cadaveric study

Cited by 11 publications

References 11 publications

Correlation between the Type of Arterial Vascularizacion and Presence and Localization of Myocardial Bridges

Correlation between the Type of Arterial Vascularizacion and Presence and Localization of Myocardial Bridges

Accuracy of exercise tolerance test in the diagnosis of coronary artery disease in patients with left dominant coronary circulation

Current mechanisms of low graft flow and conduit choice for the right coronary artery based on the severity of native coronary stenosis and myocardial flow demand

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