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Vol 79, No 3 (2020)
Case report
Submitted: 2019-08-13
Accepted: 2019-09-26
Published online: 2019-09-27
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Dual left anterior descending coronary artery (type III) and the presence of myocardial bridges: a post-mortem examination

G. Wróbel1, M. Spałek12, J. Spałek3, T. Kuder1
DOI: 10.5603/FM.a2019.0107
·
Pubmed: 31565785
·
Folia Morphol 2020;79(3):634-639.
Affiliations
  1. Department of Anatomy, Institute of Medical Sciences, Collegium Medicum, Jan Kochanowski University, Kielce, Poland
  2. Radiology and Diagnostic Imaging Department, Swietokrzyskie Oncology Centre, Kielce, Poland
  3. Collegium Medicum, Jan Kochanowski University, Kielce, Poland

open access

Vol 79, No 3 (2020)
CASE REPORTS
Submitted: 2019-08-13
Accepted: 2019-09-26
Published online: 2019-09-27

Abstract

An observational examination of the heart was performed in the Department of Anatomy, during the routine autopsy of an 89-year-old man. The heart was fixed in 10% formalin and an analysis of arterial vasculature was performed (used morphometric abbreviations below [mm]: L — length; D — diameter of origin). Trifurcation of the left main coronary artery (L = 17.4; D = 8.1) was observed during the study, which originated in the left aortic sinus and was followed by three branches: proper left anterior descending artery (pLAD; L = 11.2; D = 7.4), intermediate branch (L = 98.6; D = 3.5) and left circumflex artery (L = 104.2; D = 4.9), respectively. In the pLAD division, there was noted LAD1 (long) which was running in the interventricular septum (L = 32.2) and further in the subepicardial segment (L = 109.3) in the anterior interventricular groove towards the apex (AC) (LAD1; L = 141.4; D = 6.3) and LAD2 (short) running subepicardial in the anterior interventricular groove in the AC direction (LAD2; L = 68.4; D = 3.2). Four diagonal branches (DB) and 9 septal perforators (SP) were observed in the course of LAD1; regarding the LAD2 there were 6 SP only. It is worth noting that the first SP supplying the interventricular septum came from LAD2. Another interesting aspect of the observation was the occurrence of 4 myocardial bridges on the LAD1, LAD2, DB1 arteries and on the second obtuse marginal branch (OM2), respectively.

This case describes a rare anatomical anomaly of the LAD course and reminds clinicians of the need for careful planning of cardiac surgeries and percutaneous interventions on the coronary arteries.

Abstract

An observational examination of the heart was performed in the Department of Anatomy, during the routine autopsy of an 89-year-old man. The heart was fixed in 10% formalin and an analysis of arterial vasculature was performed (used morphometric abbreviations below [mm]: L — length; D — diameter of origin). Trifurcation of the left main coronary artery (L = 17.4; D = 8.1) was observed during the study, which originated in the left aortic sinus and was followed by three branches: proper left anterior descending artery (pLAD; L = 11.2; D = 7.4), intermediate branch (L = 98.6; D = 3.5) and left circumflex artery (L = 104.2; D = 4.9), respectively. In the pLAD division, there was noted LAD1 (long) which was running in the interventricular septum (L = 32.2) and further in the subepicardial segment (L = 109.3) in the anterior interventricular groove towards the apex (AC) (LAD1; L = 141.4; D = 6.3) and LAD2 (short) running subepicardial in the anterior interventricular groove in the AC direction (LAD2; L = 68.4; D = 3.2). Four diagonal branches (DB) and 9 septal perforators (SP) were observed in the course of LAD1; regarding the LAD2 there were 6 SP only. It is worth noting that the first SP supplying the interventricular septum came from LAD2. Another interesting aspect of the observation was the occurrence of 4 myocardial bridges on the LAD1, LAD2, DB1 arteries and on the second obtuse marginal branch (OM2), respectively.

This case describes a rare anatomical anomaly of the LAD course and reminds clinicians of the need for careful planning of cardiac surgeries and percutaneous interventions on the coronary arteries.

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Keywords

left coronary artery; dual left anterior descending coronary artery (type III); anatomical variation; morphometry; myocardial bridges

About this article
Title

Dual left anterior descending coronary artery (type III) and the presence of myocardial bridges: a post-mortem examination

Journal

Folia Morphologica

Issue

Vol 79, No 3 (2020)

Article type

Case report

Pages

634-639

Published online

2019-09-27

Page views

1203

Article views/downloads

774

DOI

10.5603/FM.a2019.0107

Pubmed

31565785

Bibliographic record

Folia Morphol 2020;79(3):634-639.

Keywords

left coronary artery
dual left anterior descending coronary artery (type III)
anatomical variation
morphometry
myocardial bridges

Authors

G. Wróbel
M. Spałek
J. Spałek
T. Kuder

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