scholarly journals Hemodynamics Study of Different Take-Off Angles of the Left Coronary Artery

Author(s):  
John J. Asiruwa ◽  
Aaron M. Propst ◽  
Stephen P. Gent

Coronary arteries are located on the surface of the heart and supply oxygenated blood to the myocardium and other components of the heart. The two coronary arteries located above the aortic arch are the Left Coronary Artery (LCA) and Right Coronary Artery (RCA). The LCA branches into the Left Anterior Descending (LAD) and the Left Circumflex (LCx) while the RCA branches into the Right Marginal Artery (RMA) and Post Descending Artery (PDA). The coronary arteries are likened to a complex tube-like structure, and the motion of the heart cause changes in pressure, which allows proper blood circulation during the systolic and diastolic phases [1]. Since it is essential to understand the physiological and hemodynamical behavior of the heart and coronary arteries, numerous studies have been conducted at different artery locations in the heart. Most of the research has focused on the branches between the LAD and LCx, with little or no attention directed towards the take-off angle the LCA makes with the aortic root. Although it has been reported that certain take-off angles of left main (LM) can be considered anomalous, findings have documented that such take off angles can make the artery prone to atherosclerosis and sudanophilia diseases [2]. Computational Fluid Dynamics (CFD) has in recent years been used to solve a wide variety of fluid flow challenges, and can be used for this study. The goal of this study is to use CFD techniques to study the hemodynamics of the different take-off angles of the left coronary artery from the aortic root. This will help identify areas in the left coronary artery that could be prone to atherosclerosis buildup.

Author(s):  
H. Hayashi ◽  
T. Yamaguchi

The beating motion of the heart wall, to which the major coronary arteries are fixed, is interesting, due to its possible mechanical influence on the flow inside the artery, and hence its effect on atherogenesis [1–2]. In this study, we conducted a computational fluid dynamics (CFD) simulation using a simplified model of the right coronary artery, which deforms with heart contractions. The results are discussed with respect to the local hemodynamics characteristics, particularly the streamline pattern and the wall shear stress distribution.


2021 ◽  
Vol 27 (4) ◽  
pp. 41-46
Author(s):  
U.Ye. Pidvalna ◽  
D.M. Beshley ◽  
M.Z. Mirchuk ◽  
L.R. Mateshuk-Vatseba

Morphometric analysis of the structures of the aortic bulb and coronary arteries is necessary for the planning of cardiac surgery and endovascular interventions. The aim of the study was to determine the height of the coronary arteries branching in healthy women of Lviv city and Lviv region and to determine the relationship between the height of the location of the orifice of the coronary artery with anthropometric indicators. Fifteen computed tomography images with contrast of female thorax without heart and ascending aortic lesions (normal) were selected for the study. The height of the upper and lower edges of the coronary arteries was measured; height of Valsalva sinuses. The comparison of the mean values was performed according to the Student’s t-test. The correlation between the observed variables (age, height, body weight, body mass index, body surface area, height of the sinuses of Valsalva) was calculated using the Pearson linear correlation method (r). According to the study, the population group consisted of persons of the second period of adulthood (46.67 %) and the elderly (53.33 %). According to the body mass index, 80 % were overweight or obese I-II degree. The mean height of the coronary artery orifice in women without structural changes of the heart and ascending aorta was: 11.19±1.96 mm for the left and 11.68±1.80 mm for the right. The height of the orifice of the right and left coronary arteries were almost the same, without statistical significance (p=0.26). Analysis of the correlation between the values of the height of the orifice of the coronary artery did not show a probable dependence on height, weight, age, body mass index and body surface area. There is a direct relationship between the parameters of the height of the lower edge of the right coronary artery and the height of the upper edge of the right coronary artery (r=+0.75, p=0.001) and between the value of the lower edge of the left coronary artery and the upper edge of the left coronary artery (r=+0.63, p=0.01). Thus, the analysis of the correlation between the values of the height of the orifice of the coronary artery in women in norm and anthropometric indicators did not show a significant relationship. There was no statistical significance between the indicators of the height of the orifice of the right and left coronary arteries in women.


2012 ◽  
Vol 3 ◽  
pp. 366-374
Author(s):  
Jarosław Wasilewski ◽  
Kryspin Mirota ◽  
Sylwia Peryt-Stawiarska ◽  
Andrzej Nowakowski ◽  
Lech Poloński ◽  
...  

2021 ◽  
pp. 20-22
Author(s):  
Sony Jhansi Priya ◽  
Sangeetha A ◽  
M. Sai Krishna

Coronary artery variations are one of the commonest variations observed during clinical procedures. Normally, there are two main coronary arteries, the right coronary artery (RCA), left coronary artery (LCA).Left coronary artery gives two important branches left circumex artery (LCX) and left anterior descending (LAD) arteries. Knowledge about the coronary vessels and its variations are essential to clinicians to prevent untoward injury of vessels during any procedures. To study the morphology and variations of coronar Aim: y arteries by dissection. Materials and Methods: The present study was a cadaveric study which was conducted on 50 hearts obtained from adult human cadavers. Coronary arteries were dissected to see the origin, course and variations. The data was entered in Microsoft excel sheet and expressed in percentage. The Right Results: coronary artery branched out from the right aortic sinus and had an average diameter of 3.5mm. The left coronary artery arouse from left aortic sinus and had an average diameter of 4mm. LMCA divided into two branches in 60 percent, three branches in 30 percent and four branches in 06 percent of the hearts and direct branches from left aortic sinuus in 4 percent hearts.Based on the origin of Posterior descending or interventricular artery, Right dominance was observed in 68 percent, left dominance in 26 percent, and equal dominance in 06 percent of the hearts. Conclusion: Knowledge about the variations of coronary vessels is a prerequisite for clinicians to perform interventions of coronary vessels.


1981 ◽  
Vol 103 (3) ◽  
pp. 208-212 ◽  
Author(s):  
B. Fox ◽  
W. A. Seed

We have correlated the location of early atheroma with vessel geometry in the major coronary arteries of subjects dying of noncardiovascular causes under 40 yr of age. We analyzed only those vessels affected minimally by very early (fatty) disease. In each of the three major branches, disease was concentrated close to the entrance and diminished with distance downstream. Circumferential distribution of disease was also not random. In the right coronary artery, lesions were concentrated on the inner wall of the major curvature. Immediately downstream of the entrances of both branches of the left coronary artery, the flow-dividing walls were spared. Further downstream in the left anterior, descending branch plaques followed a spiral distribution. We believe these patterns may be determined by local mechanical factors.


Author(s):  
Davi Tenório ◽  
Leonardo Miana ◽  
Antonio Carlos de Almeida Barbosa Filho ◽  
Monica Gonzales Coronel ◽  
Gustavo Guerreiro ◽  
...  

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.


Author(s):  
Jin Suo ◽  
Michael McDaniel ◽  
Saurabh Dhawan ◽  
Habib Samady ◽  
Don Giddens

A small isolated region with mild atherosclerotic thickening in the left anterior descending (LAD) coronary artery was identified in a relatively young patient using invasive coronary angiography. The left main (LM) coronary artery and LAD were reconstructed based on biplanar angiography images and intravascular ultrasound (IVUS). The flow field in the lumen was simulated by computational fluid dynamics (CFD) with Doppler-measured flow boundary conditions. The results offer insight into the local flow environment in the neighborhood of an early atherosclerotic plaque in a specific human subject under in vivo conditions. The investigation is continuing with other patients who have mild plaques in the left coronary artery in an effort to elucidate in vivo atherogenesis.


2019 ◽  
Vol 40 (2) ◽  
pp. 264-272
Author(s):  
Szu-Hsien Chou ◽  
Kuan-Yu Lin ◽  
Zhen-Ye Chen ◽  
Chun-Jung Juan ◽  
Chien-Yi Ho ◽  
...  

Abstract Purpose The aim of this study was to use the computational fluid dynamics (CFD) method, patient-specific electrocardiogram (ECG) signals, and computed tomography three-dimensional image reconstruction technique to investigate the blood flow in coronary arteries during cardiac arrhythmia. Methods Two patients with premature ventricular contraction-type cardiac arrhythmia and one with atrial fibrillation-type cardiac arrhythmia were investigated. The inlet velocity of the coronary artery in simulation was applied with the measured velocity profile of the left ventricular outflow tract (LVOT) from the Doppler echocardiography. The measured patient central aortic blood pressure waveform was employed for the coronary artery outlet in simulation. The no-slip boundary condition was applied to the arterial wall. Results For the patient with irregular cardiac rhythms (Case I), the coronary blood flow rate under the shortened and lengthened cardiac rhythms were 0.66 and 0.96 mL/s, respectively. In Case II, the maximum velocity at the LVOT under a normal heartbeat was found to be 101 cm/s, whereas the average value was 73 cm/s. In Case III, the patient was also diagnosed with a congenital stenosis problem at the myocardial bridge (MCB) at the LAD. The measured blood flow rate at the MCB of the LAD for the three heartbeats in Case III was found to be 0.68, 1.08, and 1.14 mL/s. Conclusion The integration of patient-specific ECG signals and image-based CFD methods can clearly analyze hemodynamic information for patients during cardiac arrhythmia. The cardiac arrhythmia can reduce the blood flow in the coronary arteries.


This chapter describes the anatomy of the coronary arteries and cardiac veins. It covers the coronary ostia and left coronary artery, the right coronary artery, the cardiac venous system, and the coronary sinus and its tributaries.


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