Coronary artery dominance: Difference between revisions
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Describes how many of the three major branches supplying the inferior wall of the heart arise from the right coronary artery (RCA) and how many arise from the circumflex artery (CX). | Describes how many of the three major branches supplying the inferior wall of the heart arise from the right coronary artery (RCA) and how many arise from the circumflex artery (CX). | ||
==Large Right Dominance== | |||
This occurs when the descending, inferior, and posterior branches all arise from the RCA. | This occurs when the descending, inferior, and posterior branches all arise from the RCA. | ||
[[Image:Large_right_dominance.gif|500px|Large right dominant]] | [[Image:Large_right_dominance.gif|500px|Large right dominant]] | ||
RD= RI =. For a full description of the labels, see the table below. | |||
===Small Right Dominance=== | ===Small Right Dominance=== | ||
Revision as of 21:13, 27 August 2013
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]; Hilda Mahmoudi M.D., M.P.H.[3]
Overview
Coronary Artery Dominance
- The dominance of coronary circulation is determined by the type of arteries that supply the posterior and inferior wall of the left ventricle.
- The artery that supplies the posterior descending artery (PDA) and the posterolateral artery (PLA) determines the coronary dominance.
- Right-dominant circulation: The right coronary artery (RCA) supplies both these arteries.
- Left-dominant circulation: The circumflex artery (CX), a branch of the left artery, supplies both these arteries.
- Co-dominant circulation: The RCA supplies the PDA and the CX supplies the PLA.
- Approximately 60% of the general population are right-dominant, 25% are co-dominant, and 15% are left-dominant.[1]
Describes how many of the three major branches supplying the inferior wall of the heart arise from the right coronary artery (RCA) and how many arise from the circumflex artery (CX).
Large Right Dominance
This occurs when the descending, inferior, and posterior branches all arise from the RCA.
RD= RI =. For a full description of the labels, see the table below.
Small Right Dominance
This occurs when the descending and inferior branches arise from the RCA and the posterior branch arises from the CX.
Co-Dominance
Co-dominance or balanced dominance occurs when only the descending branch arises from the RCA, while the inferior and posterior branches arise from the CX.
Left Dominance
This occurs when all three branches arise from the CX.
Table
| Segment number | Segment label | Segment location | Segment description | |
|---|---|---|---|---|
| 8 | RD | Right posterior descending artery | In all but left dominant systems, this vessel runs in the posterior interventricular groove and supplies septal perforator branches. When present, it is one of the three longest branches on the inferior wall of the heart. | |
| 9 | RI | Right inferior artery | Arises from the fourth segment of the right coronary artery and supplies the inferior wall. In small right dominant anatomy, it is the distal most branch arising from the right coronary artery, while in large right dominant anatomy it arises proximal to the origin of the right posterior artery. When present, it is one of the three longest branches on the inferior wall of the heart. | |
| 10 | RP | Right posterior artery | Distal most branch to arise from the right coronary artery, but present only in large right dominant systems. When present, it is one of the three longest branches on the inferior wall of the heart. | |
| 26 | C4 | Left posterolateral artery | In left dominant or balanced systems this is the distal continuation of the circumflex artery in the atrio-ventricular groove. It carries blood to the left posterior descending artery and circumflex inferior artery in left dominant systems and to just the circumflex inferior artery in balanced dominant systems. | |
| 27 | CP | Circumflex posterior artery | In all but large right dominant anatomy, this branch originates at the distal end of the third segment of the circumflex at the border of the inferior and lateral left ventricular walls where it traditionally has been called a 4th marginal branch. When present, it is one of the three longest branches supplying the inferior wall of the heart. | |
| 28 | CI | Circumflex inferior artery | Arises from the fourth segment of the circumflex and supplies the inferior wall. In balanced dominant anatomy, it is the distal most branch arising from the circumflex, while in left dominant anatomy it arises proximal to the origin of the left posterior descending artery. When present, it is one of the three longest branches on the inferior wall of the heart. | |
| 29 | CD | Left posterior descending artery | In left dominant systems this is the distal continuation of the left circumflex artery which travels in the interventricular groove and supplies septal perforators at the base of the heart. This branch is the distal continuation of the circumflex after it leaves the atrio-ventricular groove in left dominant anatomy. When present, it is one of the three longest branches on the inferior wall of the heart. |