[Coronary perfusion: classification based on the type and relative extension of coronary irrigation. Morphologic determinants].

INTRODUCTION AND OBJECTIVES

This work attempts to systematize the arterial segmentary distribution of the left ventricle and confirm the existence of coronary irrigation patterns, and determine the principals for the clinical application for diagnosis or therapeutics, using as the starting point, Selvester's classification of the arterial irrigation of the left ventricle.

METHODS

Ninety human heart specimens from autopsies were studied. The average age of the sample was 61.09 +/- 21.96 years. The range was between 4 days and 94 years old. The coronary artery tree was dissected, and each artery responsible for the irrigation of each of the twelve left ventricle segments was identified. The percentage of the muscular mass, of each segment in which the left ventricle had been divided, irrigated by each coronary artery, was obtained.

RESULTS

The analysis of the 12 segments of the left ventricle show that the three septal segments (basal, mesial and apical) present a type of irrigation which is practically constant and of a shared type. The superoapical, posterobasal and posteromesial segments present an irrigation with a high index of exclusivity for the anterior interventricular and circumflex arteries. In the rest of the segments the vascularization is of a mixed type, although the apical segments reach an important degree of arterial exclusivity.

CONCLUSIONS

The relative number of ventricular segments, exclusively irrigated by the interventricular and circumflex arteries, makes it possible to describe three groups of arterial irrigation (I, II, III), and each of them, in two subgroups (A, and B) depending on the percentage of ventricular segments irrigated in an exclusive or shared mode, by the interventricular or circumflex arteries.