Coronary arterial dominance
Updates to Article Attributes
Coronary arterial dominance is defined by the vessel gives rise to the posterior descending artery, which supplies the myocardium of the inferior 1/3rd of the interventricular septum.
Most hearts (80-85%) are leftright dominant where the PDA is supplied by the RCA. However up to 20The ramaining 15-20% of hearts may beare roughly equally divided between left dominant and codominant. The strict definition of codominance can vary depending of which modality one uses to assess the coronary arteries (coronary angiography or CTCA) but is not overly important. Regardless, in rightleft dominant, where hearts the PDA is supplied by the LCx wrapping around the LADleft atrioventricular groove or LCx orless commonly the LAD coursing around the apex of the heart. In a codominant, where heart a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx or LCx.
Although the RCA is the dominant vessel in most hearts, it is important to consider that it is usually the LCA that supplies the majority of the left ventricular myocardium as well as the anterior and mid 1/3rds of the interventricular septum
Clinical relevance
Dominance has important implications in myocardial ischaemia and infarction, imaging of the coronary arteries (CTCA and invasive coronary angiography) and the planning for coronary artery bypass grafting.
-<p><strong>Coronary arterial dominance</strong></p><p>Most hearts are <em>left dominant</em> where the PDA is supplied by the RCA. However up to 20% of hearts may be <em>right dominant</em>, where the PDA is supplied by the LAD or LCx or <em>codominant</em>, where a single or duplicated PDA is supplied by branches of both the RCA and LAD/LCx.</p>- +<p><strong>Coronary arterial dominance</strong> is defined by the vessel gives rise to the <a href="/articles/inferior-interventricular-artery">posterior descending artery</a>, which supplies the myocardium of the inferior 1/3rd of the interventricular septum.</p><p>Most hearts (80-85%) are <em>right dominant</em> where the PDA is supplied by the <a href="/articles/right-coronary-artery">RCA</a>. The ramaining 15-20% of hearts are roughly equally divided between <em>left dominant </em>and <em>codominant.</em> The strict definition of codominance can vary depending of which modality one uses to assess the coronary arteries (coronary angiography or CTCA) but is not overly important. Regardless, in <em>left dominant</em> hearts the PDA is supplied by the <a href="/articles/circumflex-artery">LCx</a> wrapping around the left atrioventricular groove or less commonly the <a href="/articles/left-anterior-descending-artery">LAD </a>coursing around the apex of the heart. In a <em>codominant</em> heart a single or duplicated PDA is supplied by branches of both the RCA and LAD or LCx.</p><p>Although the RCA is the dominant vessel in most hearts, it is important to consider that it is usually the <a title="LMCA" href="/articles/left-main-coronary-artery-1">LCA</a> that supplies the majority of the <a title="left ventricle" href="/articles/left-ventricle">left ventricular</a> myocardium as well as the anterior and mid 1/3rds of the interventricular septum </p><h4>Clinical relevance</h4><p>Dominance has important implications in <a href="/articles/myocardial-infarction">myocardial ischaemia and infarction</a>, imaging of the coronary arteries (<a href="/articles/cardiac-ct-1">CTCA </a>and invasive coronary angiography) and the planning for coronary artery bypass grafting.</p>
References changed:
- 2. Last's Anatomy. Churchill Livingstone. ISBN:0702033944. <a href="http://books.google.com/books?vid=ISBN0702033944">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/0702033944">Find it at Amazon</a><span class="auto"></span>
- 1. Clinically Oriented Anatomy. Lippincott Williams & Wilkins. ISBN:1451119453. <a href="http://books.google.com/books?vid=ISBN1451119453">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/1451119453">Find it at Amazon</a><span class="auto"></span>
- 3. Dewey M. Cardiac CT. Springer Berlin Heidelberg. ISBN:B00F76F5P2. <a href="http://books.google.com/books?vid=ISBNB00F76F5P2">Read it at Google Books</a> - <a href="http://www.amazon.com/gp/product/B00F76F5P2">Find it at Amazon</a><span class="auto"></span>
Systems changed:
- Cardiac
Sections changed:
- Anatomy
Image 1 CT (C+ CTCA) ( create )
Image 2 CT (C+ CTCA) ( create )
