Anomalies and anatomical variations in the coronary arteries and their possible implications
DOI:
https://doi.org/10.33448/rsd-v13i5.45955Keywords:
Coronary arteries; Coronary vessel anomalies; Anatomy.Abstract
With the increase in coronary procedures, understanding the anatomical patterns of the coronary arteries is becoming increasingly crucial, since they can result in implications for the patient. The aim of this study was to carry out a detailed analysis of the coronary arteries of hearts from the Human Anatomy and Pathology Laboratory at the University of Uberaba (UNIUBE). This topic was selected due to its relevance in understanding pathological changes resulting from alterations in blood flow. A cross-sectional analytical observational study was carried out over a period of 20 months: August 2022 to April 2024. The material for the study consisted of 40 preserved cadaveric hearts and data collection was based on a script with previously prepared questions, according to the cardiac anatomy described in the literature. In the study carried out, of the total number of hearts analyzed, four had an irregular coronary pathway, representing a total of 10%. Based on the universally accepted coronary branching pattern, 13 alterations were found, representing a total of 33%. Among them, the main and rarest was the double origin of the anterior descending artery, with one branch originating from the right coronary artery and one from the left coronary artery. Regarding the pattern of coronary dominance, right dominance was predominant in 87% of cases. In general, the research will contribute to a better understanding of the importance of cardiac anatomy for the understanding of clinical events, for the correct performance and interpretation of examinations and for the surgical approach to patients.
References
Angelini, P., Velasco, J. A., & Flamm, S. (2002). Coronary anomalies: incidence, pathophysiology, and clinical relevance. Circulation, 105(20), 2449–2454. https://doi.org/10.1161/01.cir.0000016175.49835.57.
Apitzsch, J., Kühl, H. P., Georg Mühlenbruch, & Mahnken, A. H. (2009). Unusual Malignant Coronary Artery Anomaly: Results of Coronary Angiography, MR Imaging, and Multislice CT. Cardiovascular Radiology/Cardiovascular and Interventional Radiology, 33(2), 389–393. https://doi.org/10.1007/s00270-009-9663-y.
Batista, A. V. S., Porto, E. A., & Molina, G. P. (2011). Estudo da anatomia da artéria coronária esquerda e suas variações: perspectivas de nova classificação. Revista Saúde & Ciência Online, 2(1), 55–65. https://doi.org/10.35572/rsc.v2i1.38.
Bozlar, U., Uğurel M. S., Sari, S., Akgün, V., Ors, F., & Taşar, M. (2015). Prevalence of dual left anterior descending artery variations in CT angiography. Diagnostic and Interventional Radiology, 21(1), 34–41. https://doi.org/10.5152/dir.2014.14275.
Braunwald, E., Zipes, D. P., & Libby, P. (2001). Heart Disease.
Castro, B. L., Ariê S., Fernando J., Martins C., Almeida, R. S., César A., et al. (1996). Dupla Origem do Ramo Descendente Anterior das Coronárias Esquerda e Direita - Associada a Origem Anômala à Direita do ramo Circunflexo. Arquivos Brasileiros de Cardiologia, 67(6), 407–409.
Chiribiri, A., Ishida, M., Nagel, E., & Botnar, R. M. (2011). Coronary Imaging With Cardiovascular Magnetic Resonance: Current State of the Art. Progress in Cardiovascular Diseases, 54(3), 240–252. https://doi.org/10.1016/j.pcad.2011.09.002.
Coyle, L., & Thomas, W. J. (2000). Anomalous left anterior descending coronary artery: Malignant hospital course of a not so benign anomaly. Catheterization and Cardiovascular Interventions, 51(4), 468–470. https://doi.org/10.1002/1522-726x(200012)51:4%3C468::aid-ccd20%3E3.0.co;2-s.
Di Guglielmo, L., & Montemartini, C. (1975). Variations anatomiques et anomalies congénitales des artères coronaires. Expérience personnelle [Anatomical variations and congenital anomalies of the coronary arteries. Personal experience (author's transl)]. Ann Radiol (Paris), 18(3), 255-257. PMID: 1225136.
Farias, D. C. C., Moreira, A. C. V., Tavares, J. M., Correia, J. N. F., Souza, R. S., & Silva Filho, A. R. da. (2013). Origem anômala da artéria coronária esquerda do seio de Valsalva direito. Revista Brasileira de Cardiologia Invasiva, 21(1), 82–84. https://doi.org/10.1590/s2179-83972013000100017.
Ferreira, S., Oliveira, D., Ramires, A., Meneguetti, C., Camargo, E., Ratti, M., Antonio, A., Lopes, G., & Bellottl, F. (1988). Anomalias congênitas de artérias coronárias: possível causa de insuficiência coronária. Arquivos Brasileiros de Cardiologia, 50(5), 285–291.
Hosalinaver, J., & Hosalinaver, A. (2018). A study of incidence of trifurcation of left coronary artery in adult human hearts. Italian Journal of Anatomy and Embryology, 123(1), 51–54. https://doi.org/10.13128/ijae-23010.
Ilia, R., Gilutz, H., & Gueron, M. (1991). Mid left anterior descending coronary artery originating from the right coronary artery. International Journal of Cardiology, 33(1), 162–165. https://doi.org/10.1016/0167-5273(91)90165-l.
Ilia, R., Weinstein, J. M., Wolak, A., Gilutz, H., & Cafri, C. (2014). Length of left anterior descending coronary artery determines prognosis in acute anterior wall myocardial infarction. Catheterization and Cardiovascular Interventions, 84(2), 316–320. https://doi.org/10.1002/ccd.24979.
King, S. B., King, S. B., & Douglas, J. S. (1985). Coronary Arteriography and Angioplasty. McGraw-Hill Companies.
Kobayashi, N., Maehara, A., Mintz, G. S., Wolff, S. D., Philippe Généreux, Xu, K., Mehran, R., C. Michael Gibson, Brener, S. J., & Stone, G. W. (2015). Usefulness of the Left Anterior Descending Artery Wrapping Around the Left Ventricular Apex to Predict Adverse Clinical Outcomes in Patients With Anterior Wall ST-Segment Elevation Myocardial Infarction (an INFUSE-AMI Substudy). The American Journal of Cardiology, 115(10), 1389–1395. https://doi.org/10.1016/j.amjcard.2015.02.034.
Mello, S. C., Carvalho, V. B., Godoy, M., Arie, S., Hironaka, F., Santos, F. L., de Oliveira, S. F., Cesar, L. A. M., & Pileggi, F. (1981). Origem anômala da artéria descendente anterior em artéria coronária direita. Relato de dois casos. Arquivos Brasileiros de Cardiologia, 37(6), 467–473.
Ortale, J. R., Meciano Filho, J., Paccola, A. M. F., Leal, J. G. P. G., & Scaranari, C. A. (2005). Anatomia dos ramos lateral, diagonal e ântero-superior no ventrículo esquerdo do coração humano. Brazilian Journal of Cardiovascular Surgery, 20, 149–158. https://doi.org/10.1590/S0102-76382005000200010.
Saremi, F., & Shavelle, D. (2013). Dual origin, course and supply in coronary artery system. International Journal of Cardiology, 168(5), 4970–4974. https://doi.org/10.1016/j.ijcard.2013.07.137.
Shriki, J. E., Shinbane, J. S., Rashid, M. A., Hindoyan, A., Withey, J. G., DeFrance, A., Cunningham, M., Oliveira, G. R., Warren, B. H., & Wilcox, A. (2012). Identifying, Characterizing, and Classifying Congenital Anomalies of the Coronary Arteries. RadioGraphics, 32(2), 453–468. https://doi.org/10.1148/rg.322115097.
Schlessinger, M. J. (1940). Significant variations in the anatomic pattern ofthe coronary vessels. Blood Heart Circul, 13(1), 93-97.
Williams, H., Williams, P. L., Alexandre Lins Werneck, & Wilma Lins Werneck. (1995). Gray anatomy.
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