Coronary artery dominance dependent collateral development in the human heart
N O Ajayi, E A Vanker, K S Satyapal1
1Department of Clinical Anatomy, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban, South Africa, South Africa. satyapalk@ukzn.ac.za.
Insights
Coronary collateral artery development is influenced by coronary artery morphology, particularly a right dominant pattern, but not by patient age or sex. This natural bypass improves blood flow in obstructive coronary artery disease.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Anatomy
Background:
- Coronary collateral arteries act as natural bypasses in obstructive coronary artery disease.
- They reroute blood flow to ischemic myocardial tissue.
Purpose of the Study:
- To investigate demographic and morphologic factors influencing coronary collateral development.
- To understand the role of coronary artery anatomy in collateralization.
Main Methods:
- Analysis of coronary angiograms from 286 patients with total coronary artery obstruction.
- Collateral flow graded (0-3) based on donor-recipient artery connections.
Main Results:
- No significant association found between patient age/sex and excellent collateral formation.
- Atherosclerotic lesion location impacted collateral development in the right coronary artery.
- A right coronary artery dominant pattern significantly enhanced collateral development.
Conclusions:
- Coronary arterial morphology, specifically a right dominant pattern, positively influences coronary collateral artery development.
- These findings highlight the anatomical basis of natural coronary bypasses.
Background:
In obstructive coronary artery disease, coronary collateral arteries serve as alternative conduits for blood flow to the myocardial tissue supplied by the obstructed vessel(s). Therefore, they are a "natural coronary arterial bypass" to the region supplied by the obstructed vessels. This study aims to determine the influence of demographic and morphologic coronary arterial factors on coronary collateral development in coronary arterial obstruction.
Materials And Methods:
The study group was selected from the coronary angiographic records of 2029 consecutive patients (mean age: 59 ± 12 years). Coronary collaterals were graded from 0 to 3 based on the collateral connection between the donor and recipient arteries. The angiograms of the patients (n = 286) with total obstruction of the coronary arteries were selected for analysis.
Results:
There were no significant association between patients' age and sex and the formation of excellent collaterals. However, the location of atherosclerotic lesion affected collateral development in the right coronary artery. In addition, the right coronary arterial dominant pattern significantly influenced the formation of excellent coronary collaterals.
Conclusions:
Coronary collateral arteries are better developed in right dominant pattern. It may be concluded that coronary arterial morphological pattern influences coronary collateral artery development.
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