ANATOMICAL STUDY OF CORONARY DOMINANCE IN CADAVERIC POPULATION OF BIKANER, RAJASTHAN

Abstract

BACKGROUND: The prevalence of Coronary heart disease (CHD) has been increasing since
last few years in developing countries like India which has rapidly increased from 1% in 1960 to
9.7% in 1995. CHD is one of the major causes of mortality and morbidity in developed countries
as well as developing countries. Whatever the etiology and patho-physiology of coronary artery
disease is, Coronary artery remains the seat of disease process. The increasing use of diagnostic
and therapeutic interventional procedures necessitates that a sound basic knowledge of coronary
artery pattern with dominance is essential. So with the increase disease burden, an in-depth
knowledge about the coronary artery is a must to understand the complete patho-physiology and
for good management of the disease. AIMS AND OBJECTIVES: To study the area of the heart
and myocardium supplied by Right and Left coronary arteries respectively and to assess
coronary predominance in the postmortem study. METHOD: A total of 70 hearts were collected
from the cadavers in the department of Anatomy and unclaimed dead bodies in the department of
Forensic Medicine, S.P. Medical College, Bikaner, Rajasthan. The hearts were preserved in 10%Formalin and dissected at a convenient time later. The coronary arteries and their branches were
carefully dissected out and followed till their termination. The modes of termination of the right
coronary artery and the circumflex artery were described with the help of five points: at the right
border, between the right border and the crux, at the crux, between the crux and the left border
and at the left border. Origin of the posterior inter-ventricular artery was taken as the basis of
coronary dominance. RESULTS: Right dominance was found in 76.67%, left dominance was
found in 13.33% while balanced pattern was observed in 10% hearts. CONCLUSION: In
present study, 76.67% of specimens showed right dominance, 13.33% left dominance and rest
10% showed balanced dominance. Knowledge of dominant pattern is significant for determining
the prognosis of coronary artery disease.