Clinically Relevant Morphometric Study Of Left Coronary Artery In Adult Human Cadavers

ABSTRACT

Background: The anatomical variations of left coronary artery [LCA] determine the course in the pathogenesis ofatherosclerosis, mechanical stress and hemodynamic change.Aim: To study the gross anatomy of left coronary artery [LCA] in terms of its origin, termination, branchingpattern, dominance pattern, external diameter at origin, length of main trunk of left coronary artery, variationsand/ anomalies if present.Materials and Methods: After an ethical approval, 150 adult human cadaveric hearts were collected fromDepartment of Anatomy, B.V.D.U. Medical College and Hospital, Sangli and Pune. The careful dissection wascarried out to note details about left coronary artery and data was analyzed using SPSS software.Results: The origin of left coronary artery was observed in the left posterior aortic sinus 100%. The incidence ofbifurcation, trifurcation and quadrifurcation was 69.33, 28% and 2.67% respectively. SA nodal artery was directlyarising from main trunk of left coronary artery in 2 hearts (1.33%). Circumflex branch of left coronary artery gaveSA nodal artery, AV nodal artery and posterior interventricular artery in 18.66%, 16% and 16% hearts respectively.In one case (0.66%), we found a hyperdominant left anterior descending artery which continued as posteriorinterventricular artery [PDA] occupying entire posterior interventricular sulcus and terminated at crux of theheart by giving AV nodal artery. Hence left dominance was observed in total 16.66% cases. The mean externaldiameter of left coronary artery at its origin was 5.02 ±1.0328. Length of main trunk of left coronary artery wasranging from 4 mm to 22 mm with mean length of 11.66±3.529 mm.Conclusion: Short or long main trunk of left coronary artery, small diameter of main trunk, additional terminalbranches of left coronary artery, left coronary artery dominance, Mouchet’s posterior recurrent interventricularartery, hyperdominanant left anterior descending artery are the significant anatomical factors which decide theextent of coronary insufficiency, its functional impact and may create challenges during the interventionalcoronary care.