Eur J Anat, 20 (2): 151-158 (2016)

Details of the origin, course, branching patterns, termination and variations of the left coronary artery â?? a cadaveric study

Tulika Gupta¹, Abhimanyu Saini², Daisy Sahni¹

¹Department of Anatomy, Postgraduate Institute of Medical Education &Research, Chandigarh, India, ²Department of Internal Medicine, John H Stroger Jr Hospital of Cook County, IL, USA

ABSTRACT Commonplace cardiac interventional procedures make detailed knowledge of the coronary vascular tree mandatory for accurate interpretation of radiological images. The present cadaveric study was proposed to document the descriptive anatomical details of the left coronary artery. Seventy-five cadaveric hearts of Indian origin were studied. The coronary vessels were injected with coloured cellulose acetate butyrate and dissected. Descriptive analysis of the course of the left coronary artery and its branches is given. Trifurcation of left coronary artery was present in 20% of the cases. Special emphasis is given to the sites of anastomoses seen. There were 4 cases of dual left anterior descending (5%). Two cases belonged to the Type II and two to the Type III. The long unusual course of the SA nodal artery was noted in about 5% (4 cases); in three cases the artery crossed the superior vena cava anteriorly and in one case it partially encircled the superior vena cava. The muscular bridge over the left coronary artery and its branches was present in 26 cases; it was located over left anterior descending in the majority of cases (16) with one each on main left diagonal artery, obtuse artery, posterior ventricular artery and posterior interventricular artery. The width of the majority (81%) of the muscular bridges was from 1-2 inch. The clinical implications of knowledge of the detailed course and anastomotic pattern of all the branches are not only diagnostic, but also therapeutic. This comprehensive description of the vessel will aid in preventing the inadvertent iatrogenic damage.

Keywords: Left coronary artery, Myocardial bridges, Anastomosis, Dual left anterior descending artery