Abstract
In 68% of cases, the left coronary ostium is at the free edge of the left sigmoid valve in 22% of cases over the edge of the valve and in 8% of cases under the free edge of the valve. In 56% of cases, the right coronary ostium is at the free edge of the left sigmoid valve in 28% of cases over the edge of the valve and in 16% of cases under the free edge of the valve. We found 5 cases with two right coronary ostium and 2 cases with two left coronary ostium. We found that in 38% of cases, the left coronary artery ends in three branches, such as anterior interventricular, circumflex and left marginal arteries, in rest of the cases, the left coronary artery ending by two branches like the anterior interventricular and circumflex arteries in which case the marginal artery originate from circumflex artery and rarely from anterior interventricular artery, or both, in this last case the left marginal artery being double. We found only 8 cases in which the circumflex artery ends as posterior interventricular artery in rest of the cases being represented by the right coronary artery end. Circumflex artery ends by two branches quite often and rarely with three branches which can sometimes be long, down to near the apex of the heart. In 8% of cases, the circumflex artery was less developed and do not vascularize other than the left side of the posterior surface of the left ventricle, sometimes his terminal ramus being left marginal artery. The right coronary artery frequently ends on diaphragmatic surface of the heart either as a single branch in posterior interventricular groove, by bifurcation or even rarely by trifurcation, when one or two branches are located in the posterior interventricular groove. Sometimes the right coronary artery ends on the posterior surface of the left ventricle, where the posterior interventricular artery occurs as collateral branch of the right coronary artery, the right coronary artery extending their vascularization territory to the posterior surface of the left ventricle, right up to the apex of the heart, the right coronary dominance, the circumflex artery in this case ending on the lateral surface of the heart. The right coronary artery may end up on the posterior surface of the right ventricle in which case posterior interventricular artery is represented by the terminal portion of the circumflex artery. The right coronary artery rarely ended as the posterior interventricular artery can reach the apex of the heart. We have found that the dominant type of a coronary artery can be held not only in the number of collateral, but also by their caliber at their origin from the aorta. We encountered 7 cases in which there is a third coronary artery, in 5 cases the third coronary artery being an anterior right I called her middle coronary artery or right ventricular branch and anterior ventricular artery, and in two cases the third coronary artery represent the circumflex artery. In 6 cases of the 7 cases described the third coronary artery showed no atrial branches
One-stage Hybrid Procedure for Patients with Valvular Pulmonary Stenosis and Coronary Artery Disease
