Ozturk Ersin, Duran Cihan, Sonmez Guner, Sildiroglu Huseyin Onur, Velioglu Murat, Bozlar Ugur, Hagspiel Klaus D
Department of Radiology, GATA Haydarpasa Teaching Hospital, Uskudar, 34668 Istanbul, Turkey.
Surg Radiol Anat. 2011 Jan;33(1):27-34. doi: 10.1007/s00276-010-0695-4. Epub 2010 Jul 7.
The objective of this study was to determine the different vascularization patterns of the posterior interventricular sulcus (PIS) with coronary CT angiography.
Three hundred and fifty-six coronary CT angiograms (CCTA) were retrospectively analyzed in 248 men and 108 women (mean age, 54.9 years ± 13.6 [standard deviation]). The PIS was divided into three segments from the crux cordis to the notch of the cardiac apex according to the American Heart Association classification (basal, mid ventricular and apical), and the artery or arteries supplying each segment were recorded. The relative frequency of the different vascularization patterns was calculated and the distribution of dominance types was recorded.
Blood was supplied to the PIS by one or more branches of the right coronary artery (RCA), the left circumflex artery (LCX), or the left anterior descending artery (LAD). We observed 25 different irrigation patterns. In the most frequent pattern (31.3%), the basal and mid-ventricular segments were perfused by a single arterial branch originating from the RCA at the crux, and the apical segment was perfused by the LAD traveling beyond the notch of the cardiac apex and entering the posterior interventricular sulcus. Of the 356 cases, the circulation was right dominant in 310 (87.1%), left dominant in 34 (9.5%), and balanced in 12 (3.4%) cases. Individual segments were perfused by a single artery in 288 (80.9%) cases, and by more than one in the remainder.
CCTA allows detailed assessment of the arterial supply of the PIS, and allowed to describe 25 subtypes. This information is of potential value to both cardiac surgeons and interventional cardiologists who plan bypass surgery or angioplasty aiming at the posterior interventricular artery.
本研究的目的是通过冠状动脉CT血管造影确定后室间沟（PIS）的不同血管化模式。
回顾性分析了248名男性和108名女性（平均年龄54.9岁±13.6[标准差]）的356例冠状动脉CT血管造影（CCTA）。根据美国心脏协会的分类（基部、心室中部和心尖部），将PIS从心脏十字交叉处至心尖切迹分为三段，并记录供应各段的一条或多条动脉。计算不同血管化模式的相对频率，并记录优势类型的分布。
PIS由右冠状动脉（RCA）、左旋支动脉（LCX）或左前降支动脉（LAD）的一个或多个分支供血。我们观察到25种不同的灌注模式。在最常见的模式（31.3%）中，基部和心室中部由起源于十字交叉处RCA的单个动脉分支灌注，心尖段由越过心尖切迹进入后室间沟的LAD灌注。在356例病例中，310例（87.1%）为右优势型循环，34例（9.5%）为左优势型循环，12例（3.4%）为均衡型循环。288例（80.9%）的单个节段由单一动脉灌注，其余病例由多条动脉灌注。
CCTA可对PIS的动脉供应进行详细评估，并可描述25种亚型。这些信息对于计划进行后室间动脉搭桥手术或血管成形术的心脏外科医生和介入心脏病学家具有潜在价值。
