Abstract

Background: The anatomical variations of left coronary artery [LCA] determine the course in the pathogenesis of atherosclerosis, mechanical stress and hemodynamic change. Aim: To study the gross anatomy of left coronary artery [LCA] in terms of its origin, termination, branching pattern, dominance pattern, external diameter at origin, length of main trunk of left coronary artery, variations and/ anomalies if present. Materials and Methods: After an ethical approval, 150 adult human cadaveric hearts were collected from Department of Anatomy, B.V.D.U. Medical College and Hospital, Sangli and Pune. The careful dissection was carried out to note details about left coronary artery and data was analyzed using SPSS software. Results: The origin of left coronary artery was observed in the left posterior aortic sinus 100%. The incidence of bifurcation, trifurcation and quadrifurcation was 69.33, 28% and 2.67% respectively. SA nodal artery was directly arising from main trunk of left coronary artery in 2 hearts (1.33%). Circumflex branch of left coronary artery gave SA nodal artery, AV nodal artery and posterior interventricular artery in 18.66%, 16% and 16% hearts respectively. In one case (0.66%), we found a hyperdominant left anterior descending artery which continued as posterior interventricular artery [PDA] occupying entire posterior interventricular sulcus and terminated at crux of the heart by giving AV nodal artery. Hence left dominance was observed in total 16.66% cases. The mean external diameter of left coronary artery at its origin was 5.02 ±1.0328. Length of main trunk of left coronary artery was ranging from 4 mm to 22 mm with mean length of 11.66±3.529 mm. Conclusion: Short or long main trunk of left coronary artery, small diameter of main trunk, additional terminal branches of left coronary artery, left coronary artery dominance, Mouchet’s posterior recurrent interventricular artery, hyperdominanant left anterior descending artery are the significant anatomical factors which decide the extent of coronary insufficiency, its functional impact and may create challenges during the interventional coronary care.

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