scholarly journals Variants of the anatomical structure of the coronary arteries and the left atrium remodeling in patients with different forms of atrial fibrillation

2018 ◽  
Vol 96 (9) ◽  
pp. 809-813
Author(s):  
Nikita L. Sharikov ◽  
S. M. Chibisov ◽  
O. N. Ragozin ◽  
S. Sh. Gasimova

One of the reasons leading to dilatation of the left atrium is atrial fibrillation. A retrospective analysis of 136 case histories of patients with various forms of “non-valvular” atrial fibrillation was performed, depending on the shape of atrial fibrillation, the patients were divided into 3 groups. In patients with atrial fibrillation in 62.5%, the source of the atrial branches was the envelope branch of the left coronary artery. Atrial branches originating from the right coronary artery system were identified in 35.8%. In men, atrial arteries occur significantly more often. The results differ from publications, according to which the blood supply of the atria and sinoatrial node from 60 to 75% is carried out by branches departing from the basin of the right coronary artery. The degree of dilatation of the left atrium does not depend on the source of blood supply, but a correlation between the size of the left atrium and the diameter of the branches of the artery of the sinatrial node in the group of patients with paroxysmal atrial fibrillation is traced.

2020 ◽  
pp. 40-47
Author(s):  
Андрей Аркадьевич Якимов ◽  
Евгения Германовна Дмитриева

Цель - выявить варианты строения и внутриорганной топографии устьев венечных артерий у взрослого человека при разных типах кровоснабжения желудочкового комплекса сердца. Материал и методы. На вскрытых через некоронарные синусы аорты 65 препаратах клапанов аорты взрослых людей изучили положение устьев венечных артерий, штангенциркулем измеряли минимальный и максимальный диаметры каждого устья, определяли их форму по соотношению диаметров. Результаты. Для устьев обеих артерий типичной была округлая, реже овальная форма. В большинстве случаев левая венечная артерия начиналась в центральной трети, правая - в центральной или задней трети «своего» синуса на уровне верхнего края полулунной заслонки или между ним и синотубулярным соединением. Локализация устьев в пределах синусов, на уровне синотубулярного соединения или выше него была редкой для обеих артерий. В 20 % случаев в правом синусе аорты спереди от устья правой венечной артерии имелось устье конусной артерии. Выводы. Типичные и редкие варианты формы правого и левого устьев, варианты их положения по вертикальной оси аорты одинаковы, варианты их положения по горизонтали различны. Зависимость вариантов формы и положения устьев от типа кровоснабжения желудочков сердца не выявлена. Objective - to reveal common and rare variants of the anatomy and intraorganic topography of the coronary orifices in normal hearts of adult human with regard to patterns of cardiac ventricular blood supply. Material and methods. On 65 specimens of aortic valves opened through non-coronary sinus, the minimal and maximal diameters of each orifice were measured with a caliper, the shape of the orifices was determined according to the ratio of the diameters, and the position of the orifices was studied. Results. The orifices of both right and left coronary arteries were mostly found to be round, less frequently oval. In most cases, the left coronary artery arose from the central third and the right artery arose from the central or posterior third of corresponding sinus at the level of the upper edge of the semilunar cusp or between the edge and the sinotubular junction. The localization of the arterial orifice within the sinuses at the level of sinotubular junction or above it was uncommon for the both arteries. In 20 % of cases, the conal artery arose with its own orifice in front of the mouth of the right coronary artery. Conclusions. Typical and rare shapes of the coronary orifices, variants of their position regarding to vertical axis of the aorta are the same, whereas variants of their position in horizontal axis are different. There is no relationship between variants of form of the orifices, position of the orifices and types of blood supply of heart ventricles.


1981 ◽  
Vol 103 (3) ◽  
pp. 208-212 ◽  
Author(s):  
B. Fox ◽  
W. A. Seed

We have correlated the location of early atheroma with vessel geometry in the major coronary arteries of subjects dying of noncardiovascular causes under 40 yr of age. We analyzed only those vessels affected minimally by very early (fatty) disease. In each of the three major branches, disease was concentrated close to the entrance and diminished with distance downstream. Circumferential distribution of disease was also not random. In the right coronary artery, lesions were concentrated on the inner wall of the major curvature. Immediately downstream of the entrances of both branches of the left coronary artery, the flow-dividing walls were spared. Further downstream in the left anterior, descending branch plaques followed a spiral distribution. We believe these patterns may be determined by local mechanical factors.


2018 ◽  
Vol 4 (2) ◽  
pp. 84-94 ◽  
Author(s):  
Tiberiu Nyulas ◽  
Emese Marton ◽  
Victoria Ancuta Rus ◽  
Nora Rat ◽  
Mihaela Ratiu ◽  
...  

Abstract Background: The independent role of each plaque feature in relation to plaque vulnerability is still the subject of ongoing research. This study aimed to compare the morphologic characteristics of vulnerable atheromatous coronary plaques with the ones of stable, non-vulnerable plaques, and in plaques with different locations in the coronary tree, in order to identify the most relevant imaging-based biomarkers associated with coronary plaque vulnerability. Material and methods: This was a prospective observational, non-randomized study that included 50 patients with unstable angina who underwent computed tomography angiography for assessment of the entire coronary artery tree followed by complex morphologic analysis of all lesions, divided into two groups: group 1 – 25 patients with vulnerable plaque (VP) and group 2 – 25 age- and gender-matched patients with non-vulnerable plaque (NVP). Results: Lesions with a stenosis degree >70% were significantly longer than those with a stenosis degree <70% (8.27 ± 2.74 mm vs. 5.56 ± 4.11 mm, p = 0.04). VP presented significantly higher values of plaque thickness (p = 0.0005), plaque burden (p = 0.0004), and higher total plaque volume (p = 0.0005) than NVP. The remodeling index was not significantly different between the groups (p = 0.6), but the eccentricity index was (0.24 ± 0.14 compared to 0.14 ± 0.17, p = 0.023). Linear regression analysis revealed a significant correlation between plaque burden and plaque components in VP (r = 0.76, p <0.0001 for necrotic core; r = 0.62, p = 0.0008 for fibro-fatty tissue; and r = 0.5, p = 0.01 for fibrotic tissue volume). Culprit plaques located in the right coronary artery presented significantly larger plaque burden volumes (91.17 ± 4.88 mm3 vs. 83.35 ± 8.47 mm3, p = 0.04), larger volumes of necrotic core (82.03 ± 47.85 mm3 vs. 45.84 ± 43.72 mm3, p = 0.02) and fibrofatty tissue (53.23 ± 31.92 mm3 vs. 23.76 ± 20.90 mm3, p = 0.02) than the ones situated in the left coronary artery. Conclusions: VPs from the culprit lesions exhibit a different phenotype than non-vulnerable ones, and vulnerability features are present in a significantly larger extent in VPs from the right coronary artery as compared to those from the left coronary artery.


2019 ◽  
Vol 12 (2) ◽  
pp. e225900
Author(s):  
Prabha Nini Gupta ◽  
Nishant Sagar ◽  
Ritesh Ramachandran ◽  
Velenurre Rajagopalan Rajeshekharan

Myxoma is a common benign tumour found in the heart. On reviewing literature, we found some left atrial myxomas receive blood supply from the right coronary artery. Performing a coronary angiogram in a cardiac tumour has the following uses: (1) it shows the vascularity that can be ligated by the surgeon at operation; (2) if there is a blood supply visible, it may not be an intracardiac thrombus; (3) the coronary angiogram may detect a myxoma even before an echocardiogram does so; (4) some myxomas may bleed into the right atrium or left atrium and this may be seen on coronary angiography. We show here the neovascularity of a left atrial myxoma and its blood supply from the right coronary artery. We recommend that all routine coronary angiograms be reviewed carefully for any signs of tumour vascularity or tumour blush as this would prevent missing early myxomas. Echocardiography is the gold standard for detection of myxomas but literature has a number of intracardiac tumours that were detected only by the tumour blush. Some left atrial tumours have been treated by occluding their blood supply.The absence of a blood supply on coronary angiography could rule out a benign cardiac tumour that usually has a blood supply.


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