ANJIOGRAFİK GÖRÜNTÜLERDE A. CORONARIA SINISTRA’NIN DALLARI ARASINDAKİ AÇININ İNCELENMESİ

Öz

Koroner arterlerdeki anatomik varyasyonlar birçok çalışmalarda tanımlanmıştır. Koroner arter varyasyonuvarlığında operasyonda damarın tanınması ve girişim açısındanönem taşımaktadır. Bununla birlikte sol koroner arterdalları arasında oluşan açılanma ile dominatlık arasındabir ilişki olup olmadığı bilinmemektedir. Bu çalışmadaMuğla Özel Yücelen Hastanesine başvuran 101 kişinin(58 erkek, 43 kadın) koroner anjiografisindeki a.coronaria sinistra görüntüleri incelenmiştir. Her vakadar. circumflexus ve r. interventricularis anterior’un solkoronerden ayrılma açıları ölçülmüştür. İncelenen tümolgularda a. coronaria sinistra mevcuttu ve sol aortiksinusdan interventricularis anterior mevcuttu ve r. circumflexus ilearalarındaki açı erkeklerde 32,87° ile 146,90° (ortalama59,83°±19,74°), kadınlarda 32,05° ile 125,25° (ortalama75,49° ±25,44°) olarak tespit edildi. Bu açı içincinsiyetler arası fark istatistiksel olarak anlamlı idi(p<0,05). R. interventricularis anterior ve r. circumflexusarasındaki açı dominantlığa göre incelendiğinde sağdominantlıkta 32,21° ila 146,9° arasında (ortalama68,30° ±24,56°), sol dominantlıkta ise 49,20° ila 130,43°arasında (ortalama 72,73°±23,44°) değişmekteydi vedominantlığa göre istatistiksel olarak anlamlı fark yoktu(p>0,05). Bu çalışmayla sol koroner arter dallarıarasındaki açı anjiyografik olarak ölçülerek cinsiyet vedominantlıklar arası farklılıklar değerlendirildiğinde solkoroner arter dalları arasında bulunan açının anjiografikgörüntülenmesinin önemli olabileceği düşünüldü

Anahtar Kelimeler

• anjiografi, koroner dominantlık, cinsiyeta. coronaria sinistra, koroner

The Examination of Angle Between Left Coronary Artery Branches in Angiography Images

Öz

Variations in the coronary artery anatomyhave been described in a number of pathologic, surgical,anatomical and angiographic studies. In case ofcoronary artery anatomic course variation, analyzing thecoronary artery angiographic findings properly isimportant for definition of the vessel peroperatorily andintervention to the vessel. However, there is not enoughknowledge about the presence or absence of arelationship between coronary artery and angle of leftcoronary artery branches. In this study, left coronaryartery images were examined by use of angiography on101 subject (58 men, 43 women) at Muğla Özel YücelenHospital. In each case, angles of the left coronary arterybranches and termination of the circumflex artery (Cx)and left anterior descending artery (LAD) were carefullymeasured. The left coronary artery, present in all cases,originated from the left aortic sinus. In all cases, its LADartery was present, between LAD and CX angles rangingfrom 32.87° to 146.90° (mean of 59.83°±19.74°), inmales; from 32.05° to125.25° (mean of 75.49°±25.44°)in females, respectively. There was a statisticallysignificant difference between the genders (P<0.05).There was not any statistically significant differencebetween the dominance (P>0.05), between LAD and CXangles ranging from 32.21 to 146.9° (mean of 68.30°±24.56°), in right dominance; from 49.20° to130.43°(mean of 72.73°±23.44°) in left dominance, respectively.When we measured angiographic angles of the LAD andCx branches of the left coronary artery and comparedgender differences, and dominance differences, it can benecessary to consider the angles of left coronary arterybranches in angiographic evaluations

Anahtar Kelimeler

• Left coronary artery, coronary angiography,coronary dominance, sex

Kaynakça

1. 1. Mcconnell MV, Ganz P, Selwyn AP, et al. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation, 1995; 92: 3158-3162.
2. 2. Ropers D, Moshage W, Danıel WG, et al. Visualization of coronary artery anomalies and their anatomic course by contrastenhaced electron beam tomography and threedimensional reconstruction. Am J Cardiol 2001; 87: 193-197.
3. 3. Zamir M, Sınclaır P. Roots and calibers of the human coronary arteries. Am J Anat 1988;183: 226-234.
4. 4. Williams PL, Warwick R, Dyson M, Bannister LH. Gray’s Anatomy. Churchill Livingstone, London. 1989; pp 1347-1375
5. 5. Schlesınger MJ. Relation of anatomic pattern to pathologic conditions of the coronary arteries. Arch Path, 1940;30:403- 415.
6. 6. Vilallonga JR. Anatomical Variations of the Coronary Arteries: The Most Frequent Variations, Eur J Anat 2003;1:29-41.
7. 7. Özcan N: Korner Kalp Hastalıkları; birinci baskı, Ankara.1997; ss.4-8.
8. 8. Baroldı G, Scomazzonı G. Coronary circulation in the normal and pathologic heart. Armed Forces Institute of Pathology; Washington D.C. 1965; pp 1-37.

9. 9. Baptista CAC, Didio LJA., TeofilovskiParafid G. Variation in Length and Termination of the Ramus Circumflexus of the Human Left Coronary Artery, Anatomischer Anzeiger 1990; 4 :247-253
10. 10. Schlesınger MJ. Relation of anatomic pattern to pathologic conditions of the coronary arteries. Arch Path, 1940;30: 403 -415.
11. 11. Pıtt B, Zoll PM, Blumgart HL, Freıman DG. Location of coronary arterial occlusions and their relation to the arterial pattern. Circulation, 1963; 28: 35-41.
12. 12. Blunk,JN, DiDio LJA. Types of coronary circulation in human hearts. Ohio State Med J 1971;67:596-607.
13. 13. Crawford T. Pathology of ischaemic heart disease. Butterworth, London-Boston, 1977; pp 1-12 and 117-122.
14. 14. Dıdıo LJA, Wakefıeld TW. Coronary arterial predominance or balance on the surface of the human cardiac ventricles. Anat Anz, 1975; 137: 147-158.
15. 15. Ortale JR, Keirella LCB. The Posterior Ventricular Branches of the Coronary Arteries in the Human Heart, Arquivos Brasileiros de Cardiologia 2004;82: 467- 472.
16. 16. Koizumi, M, Kawai, K, Honma, S, Kodama, K. Anatomical study of a left single coronary artery with special reference to the various distribution patterns of bilateral coronary arteries. Ann Anat. 2000; 182: 549-57.
17. 17. Perlmutt LM, Jay ME. Variation in Blood Supply of the Left Ventricular Apex, Investigative Radiolojy 1983; 2 :138-140.