Document Detail

Anatomic assessment of the bifurcation of the left main coronary artery using multidetector computed tomography.
MedLine Citation:
PMID:  20191272     Owner:  NLM     Status:  In-Process    
PURPOSE: Multiple techniques for stenting left main coronary artery (LMCA) bifurcation lesions exist, and an accurate understanding of normal LMCA anatomy is essential for proper diagnosis and therapeutic intervention for these lesions. The purpose of this paper is to identify various anatomic LMCA characteristics at the point of bifurcation and draw relevant clinical lessons from these characteristics.
METHODS: Two independent observers analyzed 105 cardiac dual-source computed tomography images recording LMCA length, angle of bifurcation, and cross-sectional area of the LMCA, left circumflex artery (LCX), and anterior interventricular artery (AIVA) at the point of LMCA bifurcation. Frequency of left dominance, right dominance, and codominance, as well as LMCA trifurcation was also noted.
RESULTS: Average LMCA length was 9.9 ± 4.15 (range 2-21 mm). Average angle of bifurcation between LCX and AIVA was found to be 69.3° ± 33.3° (range 14°-200°). The most frequent division of the LMCA is a bifurcation into the terminal LCX and AIVA. In 20/105 cases (19.0%) a trifurcation pattern was identified. Average cross-sectional areas at point of LMCA bifurcation were as follows for LMCA, LCX, and AIVA respectively: 12.4 ± 4.4 mm(2) (range 2.3-25.9 mm(2)), 7.4 ± 3.5 mm(2) (range 1.2-23 mm(2)), 8.5 ± 3.5 mm(2) (range 1.3-25.9 mm(2)). Frequency of heart dominance was as follows for right dominant, left dominant, and codominant 85.7, 9.5, and 4.8%, respectively.
CONCLUSION: Accurate knowledge of the in vivo anatomy of the area of bifurcation of the LMCA is essential for avoiding the misdiagnoses of diseases and for proper stent placement during percutaneous intervention in the area of bifurcation.
Kevin N Christensen; Scott R Harris; Adam T Froemming; Waleed Brinjikji; Philip Araoz; Samuel J Asirvatham; Nirusha Lachman
Publication Detail:
Type:  Journal Article     Date:  2010-02-27
Journal Detail:
Title:  Surgical and radiologic anatomy : SRA     Volume:  32     ISSN:  1279-8517     ISO Abbreviation:  Surg Radiol Anat     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-26     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8608029     Medline TA:  Surg Radiol Anat     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  903-9     Citation Subset:  IM    
Mayo Medical School, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
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