The Morphological and Radiological study of Coronary Arteries and Its Variations

Mohamed Samullah, (2020) The Morphological and Radiological study of Coronary Arteries and Its Variations. Masters thesis, Stanley Medical College, Chennai.

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Abstract

INTRODUCTION: The term coronary is derived from the Latin meaning “CROWN” that is both arteries form an oblique inverted crown within the atrioventricular groove. The right coronary artery arises perpendicularly from the anterior (right coronary) sinus and the left coronary artery arises at an acute downward angle from the left posterior (left coronary) sinus of the ascending aorta, ostia levels may vary. Heart supplies the blood to whole body during systole but it is supplied by the coronary arteries during diastole. Coronary artery disease is the second most common cause of death after HIV/AIDS among 15-59 years and it is the most common cause of death among people of age 60 years and above world wide. The management of cordiovascular diseases are becoming more and more advanced because of newer surgical and interventional techniques. These techniques need good and precise knowledge of normal coronary arteries and its variations. Numerous data on normal and anomalies of coronary arteries are available but still it needs further exploration with respect to their clinical significance. AIM OF THE STUDY: To study and assess the Anatomy of coronory arteries and to find its variations. METHODS: This study analyzed 100 healthy hearts. By dissection method 50 hearts were analysed and by coronary angiography method 50 hearts were analyzed. The parameters assessed in dissection method were origin, length, course, branching pattern/termination, dominant energy and diameter of coronary arteries, The parameters assessed in coronary angiograms were origin and dominance of coronary arteries. RESULTS: All the hearts assessed were reported to have right and left coronary arteries. The right and left coronary arteries had their origins from the anterior aortic sinus and left posterior aortic sinus respectively in all fifty specimens. The mean length of the of right coronary artery and mean length of the main trunk of left coronary artery were found to be 10.75 cms and 10.2 mm respectively and the range of length of the of right coronary artery and the main trunk of left coronary artery were found to be between 9.2 cms and 12.7 cms and 3mm to 25 mm respectively. The course of right and left coronary arteries after arising from the ascending aorta to its termination were traced and no variations were found in all 50 specimens. The termination of right coronary artery between acute margin and crux of heart in four specimens (8%), at posterior interventricular artery or crux in six specimens (12%), in between crux and obtuse margin of the heart in thirty eight specimens(76%), at the obtuse margin of the heart in two specimens(4%), The branching pattern of left coronary artery was bifurcation of main trunk of left coronary artery in thirty eight specimens (76%), trifurcation in ten specimens (20%), quadrification in one specimen (2%) and pentafurcation in one specimen (2%). Right coronary dominance was seen in forty five specimens (90%) and left dominance was seen five specimens (10%). The mean value of the right coronary artery diameter and left coronary artery diameter were 3.2mm and 4.29 mm respectively and the range of right coronary artery diameter and left coronary artery diameter is between 2.5 mm to 3.9 mm and 2.6 mm to 6.2 mm respectively in all 50 specimens. Regarding Coronary angiographic data the right and left coronary arteries had their origin from the anterior aortic sinus and left posterior aortic sinus respectively in all fifty coronary angiograms. Right coronary dominance was seen in forty two coronary angiograms (84%) and left dominance was seen six coronary angiograms (12%) and there was co dominance seen in 2 coronary angiograms (4%) in all 50 coronary angiograms. CONCLUSION: Recent advances in the study of coronary arteries make it necessary for the interventional cardiologist and the cardiothoracic surgeon to be familiar with the normal anatomy of the coronary arteries and its variations in order to perform angioplasty and coronary artery bypass grafting thereby reducing morbidity and mortality in patients suffering from coronary artery disease.

Item Type: Thesis (Masters)
Additional Information: 201733052
Uncontrolled Keywords: Heart, Coronary Arteries, Origin, Dominance and Coronary Angiogram.
Subjects: MEDICAL > Anatomy
Depositing User: Subramani R
Date Deposited: 06 Feb 2021 03:13
Last Modified: 06 Feb 2021 03:13
URI: http://repository-tnmgrmu.ac.in/id/eprint/13909

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