A Study of Coronary Artery Predominance and Its Clinical Importance (original) (raw)

Angiographic Assessment of Coronary Artery Dominance

IOSR Journals , 2019

Aim of study: To assess the dominance pattern of coronary arteries and whether it has got any clinical and therapeutic implications. Materials and method: Coronary angiography reports of 225 patients were analyzed to find dominance pattern and its correlation with severity of clinical presentation if any. Observations: Out of 225 patients , 151 presented with right dominant circulation , 46 had left dominance , 23presented with features of co-dominance, while in 5patients dominance could not be ascertained. Discussion: Dominance is decided by posterior interventricular(PIV) and posterolateral ventricular(PLV) branches. Coronary artery giving off these branches is considered to be dominant. In co-dominant circulation PIV branch comes from right coronary artery while the PLV branches are given off by circumflex branch of left coronary artery. Left dominant circulation is associated with poor treatment outcomes and worse prognosis compared to right dominant circulation in patients affected by coronary heart diseases. Conclusion: Since dominance pattern can affect treatment outcome and prognosis , so prior knowledge of coronary arterial dominance pattern can help cardiologists formulate better management protocols and explain prognosis to patients and attendants before starting treatment .

Assessment of Coronary Artery Dominance in the Indian Cadavers

International Journal of Medical and Biomedical Studies, 2018

As Coronary artery disease is one of the most common heart diseases and also the major cause of death in developing countries. The aim of the present study is to evaluate the coronary dominance pattern which will help the cardiac physicians and surgeons for better diagnosis and management of coronary artery diseases. The study was planned on 30 heart subjects. These selected hearts are without any obvious pathology referred with cardiac conditions was enrolled into the study in Andaman and Nicobar Islands Institute of Medical Science (ANIIMS) from July 2016 to July 2017.The coronary arteries were dissected and analysed for the origin of sinoatrial Nodal artery and Observations were noted. The approval of the Institutional ethical committee was taken for the present study. The hearts identified with the congenital anomalies were excluded from study. From the above study it can be concluded that the most common is the right coronary dominance compared to left and balanced dominance as seen in this study. The present study is in comparison with the data generated by previous authors. This knowledge of normal anatomy and variations of coronary dominance will help interventional cardiologist, cardio-thoracic surgeons and radiologist to plan and provide proper management to patients.

An Anatomical Study on the Coronary Arteries and Their Variations

International Journal of Anatomy and Research, 2016

Background and Aims: The term "Coronary" is derived from the Latin word "Corona", which means crown. The rise in the coronary heart disease in India has led to a rapid transition in health status.The present study is conducted to observe the origin, branching pattern and termination of the coronary arteries in human cadaveric hearts. Preponderance of right coronary dominance or left coronary dominance is also looked for in this study. Materials and Methods: 50 human hearts were collected from the embalmed cadavers of both the sexes, from the department of Anatomy of our institution. They were preserved in 10% formalin. Observation: In the present study, right coronary dominance is observed in 84% and left coronary dominance is observed in 16% of specimens. In 2% of specimen, third coronary artery is observed. 4% of short trunk (< 5 mm) and 6% of long trunk (> 15 mm) of left main coronary artery is observed. The average length of left main coronary trunk is 9.34 mm. In 14% of specimens, myocardial bridges are observed. Conclusion: Knowledge of normal anatomy of coronary arteries, its variations and anomalies related to coronary circulation is mandatory for good clinical outcome following therapeutic procedures, like angioplasty and coronary artery bypass grafting. Thus in the interest of this subject, this study is pursued.

A study of coronary dominance and its clinical significance

Folia Morphologica, 2022

Background: Coronary artery disease (CAD) is the most common cause of morbidity and mortality especially in the developing countries. The aim of the study was to find out cardiac dominance percentages and its association with coronary artery stenosis among each pattern of dominance. The objectives were to assess coronary vessel morphology of patients within each pattern of dominance, to find if gender differences exist among dominance patterns and also to find the distribution percentages of stenosis among dominance patterns. Materials and methods: Four thousand angiograms from patients of Indian origin were studied prospectively after procuring the sanction for the same from the ethical committee of the preselected hospitals from four states of South India. Informed consents were obtained. Post CABG, post PCI patients and patient being diabetic for ≥5 years were excluded from the study. Results: Right cardiac dominance was seen in 85.5%, left in 9.7%, and co-dominant in 4.8% cases. The percentages of dominance were almost similar among both genders except for left dominance which were higher among male samples. The diameter of right coronary artery (RCA-p) and left circumflex coronary artery (LCx-p) coronary arteries were significantly associated with dominance patterns (DP). The prevalence of stenosis was more for left DP, followed by right DP and least for co-dominant patterns. Conclusions: There is a necessity to see association between dominance patterns with the CAD which can help the interventional cardiologists. The disease patterns in the present study were predominantly in the left dominant or in the co-dominant hearts.

Coronary Artery Dominance Pattern in East-Godavari District: A Cadaveric Study

Journal of Evidence Based Medicine and Healthcare

With the advent of coronary angiography, coronary artery diseases can be well combated; but with time sedentary life style and stress as our constant partner have kept coronary artery disease as one of the major causes of death. Revascularization procedures demand a sound knowledge of the course of coronary arteries and their branches, both normal and their quite common variations. In this regard, posterior inter-ventricular artery (PIVA) deserves a special importance; PIVA determines the coronary dominance depending on its parent artery. Dominance can be right, left or of balanced type. Balanced type means that PIVA is derived from both right & left coronary arteries. Circulation can occur when both the coronary arteries emit a branch in that area. These and other variations form a very important repertoire of information based on which coronary bypass surgery and angioplasty can be safely and effectively performed. The aim of this study therefore is to document the coronary dominance pattern in this East Godavari district of Andhra-Pradesh. 60 adult human hearts were collected from museum of Anatomy department during the tenure of 5 years (2009 to 2014) and were preserved in 10% formalin. The hearts were dissected carefully to observe the posterior inter-ventricular artery in the posterior inter-ventricular sulcus of each heart and dominance pattern was recorded. In our present study right dominance type was the commonest (46 out of 60) followed by left dominance (10 out of 60). Only 4 out of 60 were of the balanced type. Present study, though not of the only member of its kind will definitely add up to the already existing vast knowledge, based on which various diagnostic and therapeutic intervention of coronary artery diseases can be done effectively and safely.

A study of coronary dominance pattern in central India population

IP Innovative Publication Pvt. Ltd, 2017

Aim of the study to know the coronary dominance pattern in central India population. Coronary arteries show wide variations among different populations. Origin of posterior interventricular artery was taken as the basis of dominance. The present study was undertaken on 70 adult human heart specimens from embalmed cadavers. Hearts were dissected and studied. Out of the seventy hearts studied, 55(78.57%) shows right dominance, 14(20%) shows left dominance and 1(1.42%) shows co-dominance or balanced dominance. The results of the study were compared with authors and variations were noted.

A Cadaveric Study on Coronary Dominance in South Indian Population

https://www.ijhsr.org/IJHSR\_Vol.11\_Issue.2\_Feb2021/IJHSR-Abstract.02.html, 2021

Background: Adequate insight about coronary dominance is important to understand coronary artery diseases, interpret the radiological images and to devise a proper treatment protocol in cardiovascular diseases. It determines the amount and the area of myocardium being perfused by the left or right coronary arteries. Aim: The aim of the present study is to observe the origin of posterior interventricular artery which determines the coronary dominance. Materials and Methods: The study was done on 50 formalin fixed adult heart specimens in the Institute of Anatomy, Madras Medical College irrespective of age, sex, socio-economic status, religion and education status. The coronary arteries were examined by gross dissection and analyzed statistically. Results: Right dominance was seen in 26(52%) hearts, left dominance in 10 (20%) hearts and balanced or codominance was seen in 14(28%) hearts. Discussion: The coronary artery dominance has an important clinical & surgical significance. Most of the studies have reported a higher percentage of right dominance including the present study. Conclusion: The present study on coronary dominance would be of assistance to interventional cardiologist and cardiothoracic surgeons to plan ahead during angioplasty & coronary artery bypass surgeries. Coronary dominance is also considered as an indicator in the incidence of myocardial infarction & also used as a prognostic factor during recovery.

A Study of Coronary Dominance in Population of North Karnataka

International Journal of Anatomy and Research

With the increase in the trend of modern sedentary lifestyle, the coronary heart diseases have also increased. The need to understand coronary artery anatomy in detail has become ever so important because of wide variations in the anatomy and various anomalies noted in different populations. Knowledge of coronary dominance is important to understand the severity of coronary artery diseases and plan the treatment of cardiovascular diseases. It determines the amount of myocardium that is perfused by the left or right coronary circulation. Materials and Methods: adult formalin fixed heart specimens were collected from routine under graduate and post graduate dissection at Belgaum Institute of Medical Sciences, Belagavi irrespective of sex and age. The origin of posterior interventricular artery was examined and dissected. Results were noted and compared with previous studies. Results: Out of 100 specimens studied in 83 (83 %) specimens the posterior interventricular artery was arising from right coronary artery and in other 17 (17%) specimens it arose from Left circumflex artery. In none of the specimens studied the posterior interventricular artery was arising from both the coronary arteries. Conclusion: The knowledge of normal anatomy and variations of coronary dominance will help interventional cardiologist, cardio-thoracic surgeons and radiologist of North Karnataka region in proper management of patients.

Patterns of Coronary Dominance in Patients undergoing Coronary Angiography

Birat Journal of Health Sciences, 2020

Introduction: Right and left coronary arteries supply the heart. The dominant vessel supplies posterior descending artery and at least one posterolateral branch to inferior surface of heart. The coronary circulation can be: right dominant, left dominant and co-dominant. Objectives: The aim of this study was to determine the different patterns of coronary artery dominance in patients with coronary artery disease. Methodology: A descriptive cross-sectional study was conducted in patients undergoing coronary angiography in cathlab of Nobel Medical College and Teaching Hospital, Biratnagar, Nepal. The coronary angiography was taken from all standard views. For assessing the left dominance, left anterior oblique cranial view was specially focused. Results: There were 72.9% right dominant, 22.2% left dominant and 4.9% co-dominant cases. Both sexes had similar patterns of coronary dominance (73.8% RD, 22.2% LD and 4.0% CD among males whereas, 71.4% RD, 22.1% LD and 6.5% CD among females) a...

A study of the distribution of the left coronary artery - clinical importance

European journal of anatomy, 2013

The object of the present work was to study the origin of the left coronary artery, its branches, and to note any variations in its distribution. Fifty human hearts were procured from dissection-room cadavers of adult age groups. The left coronary arteries were dissected meticulously; their individual branches and any variations encountered were noted. The left coronary artery was seen originating in relation to the left posterior aortic sinus in 100% of the specimens. The incidence of bifurcation of the left coronary artery was found in 64% and trifurcation in 36%. In 26% of hearts the circumflex branch of the left coronary artery crossed the crux, in 20% the SA Nodal artery, and in 24% the AV Nodal artery was seen as a branch of the circumflex artery. 2% incidence of retroaortic course of the left circumflex artery was observed. The left coronary artery and its branches are responsible for the irrigation of most of the left ventricle and part of the right ventricle. In case of tri...