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A clinically useful coding system for normal coronary artery anatomy.

W V Vieweg, D C Smith, A D Hagan

    Catheterization and Cardiovascular Diagnosis
    |January 1, 1975
    PubMed
    Summary
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    This study analyzed coronary arteriograms to map normal coronary artery anatomy and identify graftable vessels. A classification system was developed to aid in comparing and interpreting coronary artery anatomy for surgical planning.

    Area of Science:

    • Cardiovascular Anatomy
    • Interventional Cardiology
    • Surgical Planning

    Background:

    • Normal coronary artery anatomy is crucial for surgical planning.
    • Identifying potentially graftable vessels requires precise anatomical understanding.
    • Existing classification methods may lack sufficient detail for comparative analysis.

    Purpose of the Study:

    • To describe normal coronary artery anatomy and the distribution of potentially graftable vessels.
    • To develop a simple classification system for coronary artery origins.
    • To facilitate accurate comparison in published series and assist coronary arteriographers.

    Main Methods:

    • Review of cine coronary arteriograms from 121 patients with normal coronary arteries.
    • Categorization of arteriograms into right, mixed, and left interior emphasis systems based on left ventricular inferior surface blood supply.

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  • Development of a lettering and numbering code to describe coronary artery origins relative to the left anterior descending (LAD) coronary artery.

    • Main Results:

    • The diameter of the LAD at its origin averaged 4.2 mm.
    • Vessels greater than 70% of the LAD diameter were considered graftable.
    • Frequency of graftable vessels varied by system: Right Coronary Artery (100%, 100%, 0%), LAD (100%, 100%, 100%), Intermediate Artery (8.7%, 12.5%, 33.3%), Obtuse Marginal Artery (53.7%, 43.7%, 44.4%), Atrioventricular Groove Artery (0%, 56.2%, 100%), Diagonal Branch of LAD (15%, 6.3%, 11.1%).

    Conclusions:

    • A simple classification method for coronary artery anatomy can improve comparative analysis.
    • This system aids coronary arteriographers in interpreting findings.
    • Accurate anatomical description is vital for identifying graftable vessels in coronary artery bypass grafting.