Aim To determine the value of angles between the left coronary artery main trunk (LMT) and its branches, the anterior interventricular branch (LAD) and the circumflex branch (CX), and their possible relationship with the LMT length. Methods A total of 29 cadaveric hearts were used. The left coronary artery and its branches were dissected. The hearts were then classified according to the number of branches. The LMT length was measured with a digital gauge, and the LAD-CX angle, LMT-LAD angle and LMT-CX angle with a manual goniometer. Results The average value of the LMT length was 9.0 mm (6.0-13.5). In 20 (68.97%) samples, the LMT was divided into two terminal branches. There was no statistically significant difference (p=0.321) in LMT length between the hearts with a bifurcation and without it. The average value of the LAD-CX angle was 89.0⁰ (74.5-93.0), with a statistically significant difference (p=0.020) comparing to hearts with trifurcation. The mean value of the LMT-LAD angle was 30.83±9.23⁰ and it was significantly lower (p=0.006) in the group of hearts with bifurcation compared to the group with trifurcation of the main trunk. Conclusion The LMT length shows great variability and is not related to the LAD-CX, LMT-LAD or the LMT-CX angle. Knowledge of the left coronary variation is essential in order to avoid misinterpretation of arteriogram.
Francois J, Kariyanna P, Jayarangaiah A, Matthew T, Mcfarlane I. Absence of the Left Main Artery with Separate Ostia of the Left Anterior Descending Artery and Circumflex from the Left Sinus Valsalva: A Case. Report Am J Med Case Rep. 2020;134–6.
2.
Graidis C, Dimitriadis D, Karasavvidis V, Dimitriadis G, Argyropoulou E, Economou F, et al. Prevalence and characteristics of coronary artery anomalies in an adult population undergoing multidetector-row computed tomography for the evaluation of coronary artery disease. BMC Cardiovasc Disord. 2015;112.
3.
Ashraf S, Salman S, Ali N, Kulshreshtha S, Saad M. A rare presentation of angina and arrhythmia in absent left main coronary artery. Cureus. 2020;12142.
4.
Yang F, Ma G. Anomalous origin of left anterior descending and circumflex coronary artery from two separate ostia in the right sinus of Valsalva with unusual dominant right coronary artery. J Invasive Cardiol. 2010;180–2.
5.
Pereira Da Costa S, De D, Silva L, Andrade P, Martins V, Karline N, et al. Anatomical study of length and branching pattern of the main trunk of the left coronary artery. Morphologie. 2019;17–23.
6.
Roy S, Gupta A, Nanrah B, Verma M, Saha R. Morphometric study of left coronary artery trunk in adult human cadavers: a study on the eastern region population. J Clin Diagn Res. 2014;7–9.
7.
Dombe D, Anitha T, Giri P, Dombe S, Ambiye M. Clinically relevant morphometric analysis of the left coronary artery. Int J Biol Med Res. 2012;1327–30.
8.
Gazetopoulos N, Ioannidis P, Marselos A, Kelekis D, Lolas C, Avgoustakis D, et al. Length of main left coronary artery about atherosclerosis of its branches. A coronary arteriographic study. Br Heart J. 1976;180–5.
9.
Morbiducci U, Kok A, Kwak B, Stone P, Steinman D, Wentzel J. Atherosclerosis at arterial bifurcations: evidence for the role of haemodynamics and geometry. Thromb Haemost. 2016;484–92.
10.
Malvè M, Gharib A, Yazdani S. Tortuosity of Coronary Bifurcation as a Potential Local Risk Factor for Atherosclerosis: CFD Steady State Study Based on In Vivo Dynamic CT Measurements. Ann Biomed Eng. 2015;82–93.
11.
Konishi T, Yamamoto T, Funayama N, Nishihara H, Hotta D. Relationship between left coronary artery bifurcation angle and restenosis after stenting of the proximal left anterior descending artery. Coronary Artery Disease. 2016;449–59.
12.
Moon S, Byun J, Kim J, Kim S, Kim K, Jung J, et al. Clinical usefulness of the angle between a left main coronary artery and left anterior descending coronary artery for the evaluation of obstructive coronary artery disease. PLoS One. 2018;202249.
13.
Reig J, Petit M. Main trunk of the left coronary artery: anatomic study of the parameters of clinical interest. Clin Anat. 2004;6–13.
14.
Deepa D, Yogesh D, Randhir S, Prakash C. Main trunk of left coronary artery: anatomy and clinical implications. JMSCR. 2017;15658–63.
15.
Girasis C, Serruys P, Onuma Y, Colombo A, Holmes Dr Jr, Feldman T, et al. 3-Dimensional bifurcation angle analysis in patients with left main disease: a substudy of the SYNTAX trial (SYNergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery). JACC Cardiovasc Interv. 2010;41–8.
16.
Pflederer T, Ludwig J, Ropers D, Daniel W. Achenbach S. Measurement of coronary artery bifurcation angles by multidetector computed tomography. Invest Radiol. 2006;793–8.
17.
Rodriguez-Granillo G, Rosales M, Degrossi E, Durbano I, Rodriguez A. Multislice CT coronary angiography for the detection of burden, morphology, and distribution of atherosclerotic plaques in the left main bifurcation. Int J Cardiovasc Imaging. 2007;389–92.
The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.
