Variabilitatea morfologică a arterelor coronariene şi a ramurilor lor

Abstract

Abstract Background: Coronary pathology has a leading place in general mortality group. Frequent usage of the methods of intra-luminal coronary plasty requires an advanced knowledge of the anatomy of the coronary arteries, their individual variants of branching of morph metric parameters etc. The aim of the study: studying individual anatomical variability of subepicardial coronary branches. Material and methods: Subepicardial arteries particularities highlighted by anatomical dissection after V. P. Vorobyev, B. Z. Perlin etc., and morphological study was based on 200 human hearts of adults and children. Results: The origin of most of the coronary arteries was considered typical. We described three basic variants of branching of the main trunk of the left coronary artery: bivascular, threevascular and multivascular. Particular attention was paid to the curvatures of the coronary arteries, as one of morphological factors that aggravate cardiac perfusion and enhance coronary atherosclerosis. They were analyzed according the shape of the heart, presence of the myocardial bridges and others. With the purpose of assessing the degree curvatures variants of coronary vascular elements were described 3 types of curvatures of coronary arteries. Conclusions: 1. Coronary arteries and their branches are characterized by a hudge variability of the structure, location and number; 2. In addition to morphological factors, which induce ischemic suffering of the heart, subepicardial arterial coronary flexures in some conditions can aggravate myocardial ischemia; 3. There is a direct association between coronary flections and the shapes of the hearts. The most frequent association between the shape of the heart and the flexures of the vessels is proper for round shaped hearts; 4. Coronary flexures are twice less on the vessel covered by myocardial bridges.