冠状动脉和冠状静脉的解剖(英文)
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1R2LCx
pattern
Right coronary artery
~ 9.8cm 1)Conus artery/ Infundibular/ Third coronary/ Adipose
/Arteria of Vieussens - Separate ostium in 23% - 51% - Circle of Vieussens
6) Postero-lateral branches to the LV
- Inferior wall of the LV
Clinical division of the RCA
• Proximal - Ostium to 1st main RV branch • Mid - 1st RV branch to acute marginal branch • Distal - acute margin to the crux
Clinical division of the LAD
• Proximal - Ostium to 1st major septal perforator • Mid - 1st perforator to D2 (90 degree angle) • Distal - D2 to end
Left circumflex artery
12 -20% , males
Right coronary artery
4) Posterior descending artery - Dominance - Posterior septal branches - < 15mm 5) AV nodal artery - 80 -90%
Right coronary artery
- Right ventricular branches( left conal/pre-infundibular A)
- ~ 10 septal perforating branches (40-80mm X 0.5-1.2mm) anchors the LAD
LADBaidu Nhomakorabeacontd)
- 1st proximal septal A is prominent (His Bundle and LBB) - Myocardial bridging – 0.5-1.6% overall (28% in children) - Rarely dual LADs
Pericardium (Epicardium)
Myocardium
Epicardial Vessel Subepicardium
Subendocardium
• LCA ostium ~ 4mm • RCA ostium~ 3.2mm
The LEIDEN convention
• Each artery arises from respective aortic sinuses - Right coronary sinus(anterior) - Left coronary sinus(left posterior) - Non-coronary sinus(right posterior)
Left coronary artery
LMCA - 10-15mm(upto 30mm) length & 3-6mm(upto 10mm
diameter) - Trifurcates in 1/3rd : Ramus intermedius/ median artery/ left
diagonal artery/straight LV artery - Rare variations – absent LMCA/ pentafurcation
- ~9.3 cm long ; 1.5 -5mm - Left atrial branches - Kugel’s artery (Arteria anastomotica auricularis magna) - LV branches are called the Obtuse marginal arteries
Left anterior descending artery
- ~ 14.7 cm ;
Type I (22%) , Type II & Type III
- 2-9 diagonal branches
- 90deg bend after turning around P. conus as it gives off 2nd diagonal branch
Right coronary artery
2) Atrial branches of the RCA - < 1mm - SA nodal artery ( Ramus crista terminalis) – 55-65%
Right coronary artery
3) Right ventricular branches - Acute right marginal artery - Ramus crista supraterminalis (Superior septal artery) –
Coronary arterial anatomy
• 1st anatomical drawings- Leonardo da Vinci • Oblique inverted crown
• The coronary arteries and their major branches are sub-epicardially located
Anatomy of the coronary circulation &
Angiographic VISUALIZATION
Dr Sandeep Mohanan Department of Cardiology
Calicut Medical College 1/10/12
OUTLINE
• Coronary arterial anatomy • Variations in coronary circulation • Coronary venous anatomy • Angiographic views of coronary arteries
pattern
Right coronary artery
~ 9.8cm 1)Conus artery/ Infundibular/ Third coronary/ Adipose
/Arteria of Vieussens - Separate ostium in 23% - 51% - Circle of Vieussens
6) Postero-lateral branches to the LV
- Inferior wall of the LV
Clinical division of the RCA
• Proximal - Ostium to 1st main RV branch • Mid - 1st RV branch to acute marginal branch • Distal - acute margin to the crux
Clinical division of the LAD
• Proximal - Ostium to 1st major septal perforator • Mid - 1st perforator to D2 (90 degree angle) • Distal - D2 to end
Left circumflex artery
12 -20% , males
Right coronary artery
4) Posterior descending artery - Dominance - Posterior septal branches - < 15mm 5) AV nodal artery - 80 -90%
Right coronary artery
- Right ventricular branches( left conal/pre-infundibular A)
- ~ 10 septal perforating branches (40-80mm X 0.5-1.2mm) anchors the LAD
LADBaidu Nhomakorabeacontd)
- 1st proximal septal A is prominent (His Bundle and LBB) - Myocardial bridging – 0.5-1.6% overall (28% in children) - Rarely dual LADs
Pericardium (Epicardium)
Myocardium
Epicardial Vessel Subepicardium
Subendocardium
• LCA ostium ~ 4mm • RCA ostium~ 3.2mm
The LEIDEN convention
• Each artery arises from respective aortic sinuses - Right coronary sinus(anterior) - Left coronary sinus(left posterior) - Non-coronary sinus(right posterior)
Left coronary artery
LMCA - 10-15mm(upto 30mm) length & 3-6mm(upto 10mm
diameter) - Trifurcates in 1/3rd : Ramus intermedius/ median artery/ left
diagonal artery/straight LV artery - Rare variations – absent LMCA/ pentafurcation
- ~9.3 cm long ; 1.5 -5mm - Left atrial branches - Kugel’s artery (Arteria anastomotica auricularis magna) - LV branches are called the Obtuse marginal arteries
Left anterior descending artery
- ~ 14.7 cm ;
Type I (22%) , Type II & Type III
- 2-9 diagonal branches
- 90deg bend after turning around P. conus as it gives off 2nd diagonal branch
Right coronary artery
2) Atrial branches of the RCA - < 1mm - SA nodal artery ( Ramus crista terminalis) – 55-65%
Right coronary artery
3) Right ventricular branches - Acute right marginal artery - Ramus crista supraterminalis (Superior septal artery) –
Coronary arterial anatomy
• 1st anatomical drawings- Leonardo da Vinci • Oblique inverted crown
• The coronary arteries and their major branches are sub-epicardially located
Anatomy of the coronary circulation &
Angiographic VISUALIZATION
Dr Sandeep Mohanan Department of Cardiology
Calicut Medical College 1/10/12
OUTLINE
• Coronary arterial anatomy • Variations in coronary circulation • Coronary venous anatomy • Angiographic views of coronary arteries