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Segmentary analysis of the coronary artery distribution in the left ventricle

Analyse segmentaire de l'irrigation artérielle coronaire du ventricule gauche

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Summary

In a series of 90 human hearts, from individuals aged between 4 days and 94 years (X=61.09±21.96) the coronary arterial distribution of the left ventricle (LV) was studied using Selvester's system of segmentation[24]. Postmortem angiographies and micro-dissection techniques were used. The analysis of the 12 segments of the LV showed that the three septal segments (basal, mesial and apical) present a type of irrigation which is practically constant and of a dual type. The superoapical, posterobasal and posteromesial segments present an irrigation with a high index of exclusivity for the anterior interventricular and circumflex arteries. In the rest of the segments the vascularization is of a mixed type, although the apical segments reach an important degree of arterial exclusivity. The analysis by segments of the LV allows us to conclude that the arterial vascularization of the left ventricle depends fundamentally on the anterior interventricular artery and the left circumflex artery, which are those that present the greatest extension, together with a small contribution by the right coronary artery, which is always minor with respect to the left coronary artery.

Résumé

Sur une série de 90 coeurs, prélevés chez des sujets âgés de 4 jours à 94 ans (X=61,09±21,96) la distribution artérielle coronaire du ventricule gauche (VG) a été étudiée, en utilisant la classification des segments de Selvester, par angiographie post-mortem et microdissection. L'analyse des 12 segments du VG montre que les trois segments septaux (basal, médial et apical) présentent un type d'irrigation pratiquement constant, le type dual. Les segments supéro-apical, postéro-basal et postéro-mésial ont un indice élevé d'exclusivité pour les artères interventriculaire antérieure (IVA) et circonflexe (CX). Pour les autres segments, la vascularisation est de type mixte, quoique les segments apicaux présentent un haut degré d'exclusivité. L'analyse par segments du VG nous permet de conclure que la vascularisation artérielle de ce ventricule dépend fondamentalement de l'IVA et de la CX. Le petit apport de la coronaire droite (CD) est toujours mineur en regard de celui de la coronaire gauche.

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References

  1. Banchi A (1904) Morfologia delle arteriae coronarie cordis. Arch Ital Anat Embriol 3: 87–164

    Google Scholar 

  2. Baroldi G, Scomazzoni G (1965) Coronary circulation in the normal and pathologic heart. US Government Printing Office, American Registry of Pathology, Armed Forces Institute of Pathology, Washington DC

    Google Scholar 

  3. Bizarro RO (1971) Myocardial scar: Morphologic and vectocardiographic study. Thesis; University of Minnesota

  4. Bosco GA (1935) Diagnóstico anatomotopográfico de la obstrucción arterial coronaria. Artes gráficas modernas, Buenos Aires

    Google Scholar 

  5. Boyden EA (1955) Segmental anatomy of the lungs. Mcgraw-Hill, New York

    Google Scholar 

  6. Cohen MV (1985) Coronary collaterals: Clinical and experimental observations. Futura, New York

    Google Scholar 

  7. Corrons J (1990) Irrigación arterial coronaria del ventrículo izquierdo: Aportación del análisis segmentario. Tesis; Universidad de Barcelona

  8. Couinaud C (1957) Le foie: études anatomiques et chirurgicales. Masson, Paris

    Google Scholar 

  9. De Souza NA (1975) A quantitative morphologic, vectocardiographic and clinical study of some malconformations of the human myocardium. Thesis; University of Minnesota

  10. Di Dio LJA, Rodrigues H (1983) Cardiac segments in the human heart. Anat Clin 5: 115–124

    Google Scholar 

  11. Edwards WD, Tajik AJ, Seward JB (1981) Standardized nomenclature and anatomic basis for regional tomographic analysis of the heart. Mayo Clin Proc 56: 479–497

    Google Scholar 

  12. Hagan AD, Di Sessa FG, Bloor CM, Calleja HR (1983) Two-dimensional echocardiography. Little & Brown, Boston, pp 163–226

    Google Scholar 

  13. Hamilton GW, Trobaugh GB, Ritchie JL, Williams DL, Weaver WD, Gould KL (1977) Myocardial imaging with intravenously injected Thallium-201 in patients with suspected coronary artery disease. Am J Cardiol 39: 347–354

    Google Scholar 

  14. Ideker RE, Wagner GS, Ruth WK, Alonso DR, Bishop SP, Bloor CM, Fallon JT, Gottlieb GJ, Hackel DB, Phillips HR, Reimer KA, Roark SF, Rogers WJ, Savage RM, White RD, Selvester RH (1982) Evaluation of a QRS scoring system for estimating myocardial infarct size. II Correlation with quantitative anatomic findings for anterior infarcts. Am J Cardiol 49: 1604–1614

    Google Scholar 

  15. James TN (1968) The coronary circulation and conduction system in acute myocardial infarction. Prog Cardiovasc Dis 10: 410–452

    Google Scholar 

  16. Kalbfleisch H, Hort W (1977) Quantitative study on the size of coronary artery supplying areas postmortem. Am Heart J 94: 183–188

    Google Scholar 

  17. Rigo P, Bailey IK, Griffith LSC, Pitt B, Burow RD, Wagner HN, Becker LC (1980) Value and limitations of segmental analysis of stress Thallium myocardial imaging for localization of coronary artery disease. Circulation 61: 973–981

    Google Scholar 

  18. Roark SF, Ideker RE, Wagner GS, Alonso DR, Bishop SP, Bloor CM, Bramlet DA, Edwards JE, Fallon JT, Gottlieb GJ, Hackel DB, Phillips HR, Reimer KA, Rogers WJ, Ruth WK, Savage RM, White RD, Selvester RH (1983) Evaluation of a QRS scoring system for estimating myocardial infarct size. II Correlation with quantitative anatomic findings for inferior infarcts. Am J Cardiol 51: 382–389

    Google Scholar 

  19. Savage RM, Wagner GS, Ideker RE, Podolsky SA, Hackel DB (1977) Correlation of postmortem anatomic findings with electrocardiographic changes in patients with myocardial infarction. Circulation 55: 279–285

    Google Scholar 

  20. Sayen JJ, Sheldon WF (1949). The heart muscle and the electrocardiogram in coronary disease. II Difficulties of description and illustration of ventricular muscle lesions, with a method for their graphic representation in a myocardial map. Am Heart J 38: 688–701

    Google Scholar 

  21. Sayen JJ, Sheldon WF, Wolferth CC (1955) The heart muscle and the electrocardiogram in coronary disease. III A new classification of ventricular myocardial damage derived from the clinicopathologic findings in 100 patients (Part One). Circulation 12: 321–337

    Google Scholar 

  22. Sayen JJ, Sheldon WF, Wolferth CC (1955) The heart muscle and the electrocardiogram in coronary disease. III A new classification of ventricular myocardial damage derived from the clinicopathologic findings in 100 patients (Part Two). Circulation 12: 530–542

    Google Scholar 

  23. Schaper W (1971) The collateral circulation of the heart. North Holland, Amsterdam

    Google Scholar 

  24. Selvester RH, Sanmarco ME, Solomon JC, Wagmer GS (1982) The ECG: QRS change. In: Wagner GS (ed) Myocardial Infarction: measurement and intervention. Martinus Nijhoff, The Hague Boston London, pp 23–50

    Google Scholar 

  25. Sheehan FH (1989) Left ventricular dysfunction in acute myocardial infarction due to isolated left circumflex coronary artery stenosis. Am J Cardiol 64: 440–447

    Google Scholar 

  26. Smith GT (1963) The renal vascular patterns in man. J Urol 89: 275–288

    Google Scholar 

  27. Vieweg WVR, Alpert JS, Johnson AD, Dennish GW, Nelson DP, Warren SE, Hagan AD (1980) Distribution and severity of left ventricular wall motion abnormalities according to age and coronary arterial pattern in 500 patients with coronary artery disease and angina pectoris. Am Heart J 99: 707–713

    Google Scholar 

  28. Wagner GS, Freye CJ, Palmeri ST, Roark SF, Stack NC, Ideker RE, Harrell FE, Selvester RH (1982) Evaluation of a QRS scoring system for estimating myocardial infarct size. I Specificity and observer agreement. Circulation 65: 342–347

    Google Scholar 

  29. Ward RM, White RD, Ideker RE, Hindman NB, Alonso DR, Bishop SP, Bloor CM, Fallon JT, Gottlieb GJ, Hackel DB, Hutchins GM, Phillips HR, Reimer KA, Roark SF, Rochlani SP, Rogers WJ, Ruth WK, Savage RM, Weiss JL, Selvester RH, Wagner GS (1984) Evaluation of a QRS scoring system for estimating myocardial infarct size. II: Correlation with quantitative anatomic findings for posterolateral infarcts. Am J Cardiol 53: 706–714

    Google Scholar 

  30. Zamir M, Silver MD (1985) Morphofunctional anatomy of the human coronary arteries with reference to myocardial ischemia. Can J Cardiol 1: 363–372

    Google Scholar 

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Authors and Affiliations

  1. Cardiac Morphology Section; Experimental Laboratory, Cardiology Department “Sant Jordi”, Cardiovascular Surgical Centre, Barcelona, Catalunya, Spain

    J Reig, A Jornet & M Petit

  2. Dept. Ciencies Morfologiques, Facultat de Medicina, Universitat Autonoma de Barcelona, Bellaterra, E-08193, Barcelona, Catalunya, Spain

    J Reig

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  2. A Jornet
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Reig, J., Jornet, A. & Petit, M. Segmentary analysis of the coronary artery distribution in the left ventricle. Surg Radiol Anat 15, 91–97 (1993). https://doi.org/10.1007/BF01628306

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  • DOI: https://doi.org/10.1007/BF01628306

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