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Normal and variant anatomy of Left Coronary Artery : 64-Slice Multi Detector Computed Tomography ( MDCT ) Coronary Angiographic Depiction in North Indian population

AbstractThe aim of this study was to review the appearance of normal patterns of left coronary artery, its anatomic variants and anomalies and to assess their incidence in subjects of North India who underwent 64-slice Computed Tomographic Coronary Angiography (CT-CA) for suspected or known coronary artery disease (CAD). This study was carried out in the Departments of Anatomy and Radiodiagnosis, KGMU, U.P, Lucknow, India. Fifty CT Coronary Angiograms of routine subjects of either sex and of different age groups coming to the department of Radiodiagnosis were evaluated prospectively to see the normal and variant anatomy of Left Coronary Artery (LCA) regarding its origin, length of main trunk and branching pattern. In all the cases LCA arose either below the Sinotubular (ST) junction from Left Posterior Aortic Sinus (LPAS) or from ST junction except one which demonstrated a high take off from tubular part of ascending aorta. The LCA had a mean length of 7.11 ± 3.04 mm. The two main branches of LCA are Left Circumflex (LCX) artery and Left Anterior Descending (LAD) artery. This study revealed that the main trunk of LCA bifurcated into LCX artery and LAD artery in 38 (76%) subjects. The artery was seen to be trifurcating in 12 (24%) cases with the Ramus Intermedius (RI) being the third artery. Left coronary artery is one of the feeding arteries of the heart, so a detailed knowledge of its anatomy is very important. High takeoff of LCA may cause difficulty in cannulation during coronary arteriography. Its trifurcation can cause technical problems during catheterization and may be a source of complication or misdiagnosis.