الفهرس | Only 14 pages are availabe for public view |
Abstract One hundred and four patients without significant coronary artery stenosis or previous PCI or CABG were enrolled in this prospective study, mean age was (56.5±8.48 years), 46 male (44.2%) &58 female (55.8%). The age ranged from 36 to 82years. Proper history taking & physical examination were done. Invasive coronary angiography was done via the femoral approach using a standard Seldinger technique. A detailed angiographic analysis of the whole coronary tree was done using three principal investigators blind to the clinical data. Although the general scheme of coronary arteries anatomy is more or less similar, detailed analysis of the anatomy of coronary arteries including origin, termination, length, angles between major branches, distance between major branches & number of major branches proved that individual variations were sufficient to prove that there is unique coronary anatomy for every patient and thus establishing the concept of “Coronary Print”. The study showed that the prevalence of absent LMCA was5.8%, anomalous origin of LMCA from the right coronary sinus of Valsalva was 0.96%, the LMCA was ultra-short (less than 5 mm) in 2 patients (2.05%), short (5 mm-10 mm) in 17 patients (17.3%), average (10-15 mm) in 36 patients (36.7%) and long (15-25 mm) in 36 patients (36.7%) and ultra long (more than 25 mm) in 7 patients (7.14%). Also, LMCA was bifurcating into two branches in 81 patients (82.7%) and trifurcating in 17 patients (17.3%). In our study the angle of division of the terminal branches of LM was 89.7° ± 32.5°, range (30° – 191°). The number of diagonal branches originating from LAD was 1 in 1.9% of cases, 2 in 36.5%, 3 in 44.2%, 4 in 12.5%, 5 in 3.8% & 6 in 1.0% The course of LAD was early terminating in 16 patients (15.4%), terminating at the apex in 41 patients (39.4%) & extending beyond the apex in 47 patients (45.2%) (wrapping in44 patients (42.3%) & long wrapping in 3 patients (2.9%). An important finding in this study is that the left anterior descending artery is sharing in the supply of the inferior wall in 45% of the whole study group. Type IV dual LAD which is a rare anomaly was present in one case in our study (0.96%). The number of OM branches in our study was 1 in 9.6%, 2 in 45.2%, 3 in 33.7% & 4 in 11.5% of cases. The LCX was originating from RCA is one case (0.96%). The RCA had a high take-off in origin in (3.8%). RCA was terminating at proximal segment in 2.9%, terminating at mid-segment in 10.6%, reaching crux in 85.6% and super dominant in 0.96%. RCA was dominant in 78.7% of cases, LCX was dominant in 13.5% & co-dominance was present in 7.7 %. This study paves the way to further studies on larger scale to confirm the concept and then the clinical & therapeutic implications of these variations can be further determined. |