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Relevance of the Human Coronary Collateral Circulation

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Collateral Circulation of the Heart

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The symptom of angina pectoris surfaced only in the late 18th century and became more prevalent even 150 years later. For a long time, the view prevailed that angina pectoris was almost always fatal. Conversely, developing tolerance to exercise-induced angina pectoris which could even ‘cure’ it was described by William Heberden. Structural channels connecting the right and left coronary arteries were first described by Richard Lower of Amsterdam in 1669. In 1757, the Swiss anatomist Albrecht von Haller also demonstrated anastomoses between coronary arteries. The first anatomic observations of anastomoses were possibly made in non-obstructed coronary arteries, because coronary artery disease (CAD) was much less prevalent than today. Using post-mortem imaging of the coronary circulation by a multitude of different techniques, a controversy on the existence of structural intercoronary anastomoses ensued, which was not settled in their favour before the first half of the 20th century in case of the presence of CAD and not before the early 1960s in case of the normal human coronary circulation by William Fulton.

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Abbreviations

CAD:

coronary artery disease

CFI:

collateral flow index (no unit)

CK:

creatine kinase

CVP:

central venous pressure (mmHg)

HOCM:

hypertrophic obstructive cardiomyopathy

LAD:

left anterior descending artery

LCX:

left circumflex coronary artery

LV:

left ventricle, left ventricular

P ao :

mean aortic pressure (mmHg)

PCI:

percutaneous coronary intervention

P occl :

mean coronary occlusive or wedge pressure (mmHg)

RCA:

right coronary artery

TASH:

transcoronary ablation of septal hypertrophy

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  1. Klinik und Poliklinik for Kardiologie, Universitätsklinikum Bern Inselspital, Freiburgstrasse 4, 3010, Bern, Switzerland

    Dr Christian Seiler

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© 2009 Springer-Verlag London

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Seiler, C. (2009). Relevance of the Human Coronary Collateral Circulation. In: Collateral Circulation of the Heart. Springer, London. https://doi.org/10.1007/978-1-84882-342-6_1

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  • DOI: https://doi.org/10.1007/978-1-84882-342-6_1

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