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Published on: August 28, 2018
Coronary artery anatomy in peri-crux cordis area on computed coronary tomography angiography
Ming-Xing Xu1,2, Jin-Mei Liu1, Yong-Ming He1
1Division of Cardiology, The First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Insights
This study defines the peri-crux cordis area using coronary computed tomography angiography (CCTA) and identifies 8 coronary artery distributions. Findings offer insights for interventional cardiologists treating coronary artery disease (CAD).
Area of Science:
- Cardiovascular Imaging
- Cardiac Anatomy
- Interventional Cardiology
Background:
- The peri-crux cordis area's anatomy is poorly understood due to limited autopsy data.
- Standardization of peri-crux area definition on CCTA is lacking.
- Understanding coronary artery anatomy in this region is crucial for revascularization strategies.
Purpose of the Study:
- To define the peri-crux cordis area on coronary computed tomography angiography (CCTA) images.
- To investigate coronary artery anatomical distributions within the peri-crux cordis area.
- To provide anatomical insights for interventional cardiologists.
Main Methods:
- 1,006 patients undergoing CCTA were analyzed.
- The peri-crux cordis area was delineated using specific cardiac landmarks.
- Coronary artery distributions within this area were observed and categorized by sex.
Main Results:
- A standardized definition of the peri-crux cordis area on CCTA was established.
- Eight distinct types of coronary artery distributions were identified in the peri-crux cordis area.
- Type 1 right dominance was most common (82.9%). No significant sex-based differences were found.
Conclusions:
- The peri-crux cordis area can be reliably defined on CCTA, revealing 8 coronary artery distribution types.
- This anatomical knowledge aids in recognizing coronary dominance and planning revascularization for chronic total occlusions.
- Findings may improve prognosis evaluation in patients with coronary artery disease (CAD).
Background:
The peri-crux area is an anatomical structure of the heart. Unfortunately, important information on this area mainly derives from autopsy heart with a small, under-representative sample size, resulting in limited clinical applications. Furthermore, little has been done to standardize the definition of the peri-crux area on coronary computed tomography angiography (CCTA) images or to investigate coronary artery anatomy wherein potential values are attracting experienced inventional cardiologists in terms of the revascularization strategies. The current study aimed to identify the peri-crux cordis area and to observe coronary artery anatomical distributions in this area on CCTA.
Methods:
A total of 1,006 consecutive patients undergoing CCTA exams were enrolled. We delineated the peri-crux cordis area based on the posterior interatrial sulcus, posterior interventricular sulcus (PIS), left and right posterior atrioventricular groove on the diaphragmatic surface of the heart. Then we observed the coronary artery distributions in the peri-crux cordis area in different sexes.
Results:
We have defined the peri-crux cordis area according to the anatomical landmarks on the diaphragmatic surface of the heart on CCTA images. We have observed 8 coronary artery distributions in the peri-crux cordis area. Right dominance has 4 types (types 1-4); left, 1 type (type 0) and balanced, 3 types (types 5-7). Out of the 1,006 cases, the type 1 is commonest with 834 cases (82.9%). There are no statistically significant differences in terms of coronary dominances and coronary artery distributions in the peri-crux cordis area between sexes (P>0.05).
Conclusions:
We have defined the peri-crux cordis area utilizing the anatomical landmarks of the heart on CCTA images, where 8 types of coronary artery distributions have been identified. The current study may provide interventional cardiologists with useful information on recognition of coronary artery dominance, use of collateral channels for revascularization of chronic total occluded lesions, and evaluation of prognosis in patients with coronary artery disease (CAD).
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