Coronary angiography. Lesson 1: coronary artery anatomy
Coronary angiography. Lesson 1: coronary artery anatomy
The heart is supplied with the blood by coronary arteries. Coronary artery anatomy is described in this video.
Used materials: http://www.onlinejacc.org/content/43/… (AHA coronary segments modified).
Content
7.2 -> The heart is supplied with the blood by coronary
arteries.
11.02 -> Anatomically, coronary system of the heart
is divided into 2 parts: left and right.
17.08 -> There are two major coronary arteries: right
coronary artery, also called RCA, and
24.2 -> left main coronary artery, also called LMCA.
29.359 -> These coronary arteries originate from the
right and left sinuses of Valsava respectively
36.719 -> just above the level of the aortic valve.
40.17 -> At first, we will speak about the left main
coronary artery that is sometimes called as
46.539 -> the left main stem.
47.94 -> It’s short but its diameter is the largest.
52.28 -> It bifurcates into the left anterior descending
artery and circumflex artery.
58.16 -> About 30% of people additionally have intermediate
artery.
64.3 -> Left anterior descending artery (also called
LAD) is located in the anterior interventricular
71.25 -> sulcus and it goes to the apex.
74.53 -> It gives septal branches to the interventricular
septum and diagonal branches to the lateral
80.59 -> wall of the left ventricle.
83.28 -> There are 2-4 diagonal branches, that are
called first diagonal, additional first diagonal,
90.29 -> second diagonal, additional second diagonal
branches.
95.02 -> From the angiographic point of view, left
anterior descending artery is divided into
101.45 -> three parts: proximal, mid and distal.
106.13 -> As the last one is located near the apex,
sometimes it’s called apical.
112.61 -> Left anterior descending artery may wrap over
the apex and feed some part of the posterior
119.85 -> wall of the left ventricle.
122.14 -> Circumflex artery gives rise to several atrial branches,
obtuse marginal and left posterolateral branches.
131.82 -> In 15% of all people circumflex artery gives
rise the posterior descending artery, this
139.38 -> state is known as left dominant circulation.
144.36 -> Circumflex artery has 2 divisions: proximal
and intermediate.
149.27 -> In 35-40% of people the sinoatrial node artery
is branch of the circumflex artery, in other
157.52 -> people it branches out from the right coronary
artery.
162.81 -> Circumflex and left anterior descending arteries
feed the left atrium, the entire anterior
169.37 -> wall and major part of the posterior wall
of the left ventricle, major part of the anterior
176.15 -> wall of the right ventricle, the anterior
2/3 of the interventricular septum, and the
183.63 -> anterolateral papillary muscle of the left
ventricle.
187.78 -> Right coronary artery originates from the
aorta above the right cusp of the aortic valve.
195.13 -> It is located in the right coronary sulcus.
198.76 -> Often conus artery is the first branch.
202.34 -> In approximately 85% of people it gives off
posterior descending artery;
207.98 -> it’s known as right dominant circulation.
211.26 -> Right coronary artery is divided into three
parts: proximal, mid and distal.
219.11 -> Usually the distal segment of the RCA gives
2-4 posterolateral branches.
225.62 -> It’s important, that typically sinoatrial
and atrioventricuar nodes are supplied by
231.44 -> the right coronary artery, and rare they may
be supplied by the circumflex artery.
237.22 -> Often acute marginal branches from the RCA
are collateral source.
243.26 -> Also, RCA gives short branches to the interventricular
septum.
248.8 -> So, right coronary artery feeds right atrium,
entire posterior wall of the right ventricle,
257.05 -> minor part of the posterior wall of the left
ventricle, posterior 1/3 of the interventricular
263.95 -> septum, papillary muscles of the right ventricle
and posteromedial muscle of the left ventricle.
271.17 -> It’s important that anterolateral papillary
muscle is supplied by both circumflex and
277.58 -> left anterior descending arteries.
280.88 -> But posteromedial papillary muscle is supplied
only by the RCA.
286.2 -> So, posteromedial papillary muscle is less
protected against ischemia, as it’s supplied
293.15 -> by only one coronary artery.
Source: https://www.youtube.com/watch?v=dHFENbh1tKM