[冠状动脉的解剖变异]

Cavalcanti J S, de Lucena Oliveira M, Pais e Melo A V, Balaban G, de Andrade Oliveira C L, de Lucena Oliveira E

Centro de Ciências Biológicas da Universidade Federal de Pernambuco.

Arq Bras Cardiol. 1995 Dec;65(6):489-92.

PURPOSE

To study the coronary arteries and their main branches showing the aspects of source, trajectory and anastomoses of these vessels at the subepicardial level.

METHODS

The study was carried out on 110 adult human hearts, of both sexes, fixed in 10% formaldehyde solution. The pericardium was removed to expose the coronary arteries and their branches at the subepicardial level.

RESULTS

In 38.18% of the cases the left coronary artery presented a trifurcation into anterior interventricular, circunflex and left marginal branches (35.70%) and into anterior interventricular, circunflex and lateral branches (64.30%). In 60% of the hearts examined, the left coronary artery presented a bifurcation into anterior interventricular and circunflex branches. In 1.82% of the cases these two branches arise directly from the aorta. An anastomosis, at the subepicardial level, between the anterior and posterior interventricular branches was observed in 56.36% of the hearts. In 88.18% the posterior interventricular branch arised from the right coronary artery, whereas in 11.82% this vessel arises from the circunflex branch. Anastomoses between the right coronary artery and the circunflex branch were found in 10% of the hearts (crux cordis). The dominance of the right coronary artery was present in 69.09% of the cases, of the left coronary artery in 11.82% and in 19.09% of the hearts had balanced distribution.

CONCLUSION

The coronary arteries and their main branches present a great quantity of variations with regard to source, trajectory and anastomoses. This knowledge is important for the interpretation of coronary angiography and surgical myocardial revascularization.

目的

研究冠状动脉及其主要分支，展示这些血管在心外膜下层面的起源、走行和吻合情况。

方法

该研究对110例成年男女心脏进行，用10%甲醛溶液固定。去除心包以暴露心外膜下层面的冠状动脉及其分支。

结果

在38.18%的病例中，左冠状动脉呈三叉分支，分为前室间支、旋支和左缘支（35.70%）以及前室间支、旋支和外侧支（64.30%）。在60%的检查心脏中，左冠状动脉呈二叉分支，分为前室间支和旋支。在1.82%的病例中，这两个分支直接发自主动脉。在56.36%的心脏中观察到心外膜下层面前室间支和后室间支之间存在吻合。在88.18%的情况下，后室间支发自右冠状动脉，而在11.82%的情况下，该血管发自旋支。在10%的心脏中发现右冠状动脉和旋支之间存在吻合（心脏十字交叉处）。右冠状动脉优势型占69.09%的病例，左冠状动脉优势型占11.82%，19.09%的心脏分布均衡。