A CADAVERIC STUDY OF THE BRANCHING PATTERN OF RIGHT CORONARY ARTERY IN PAKISTANI POPULATION

Qazi Waheedullah, Farah Deeba, Sadia Shaukat, Samina Zahir, S. Iftikhar, Zainab Rehman
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Abstract

Background:  It is very common for coronary arteries to vary in their origin, course and area of distribution. The knowledge about these variations is unequivocally important for a cardiac surgeon and physician. However, the prevalence of such variations varies among different populations. The already available data on variations in the anatomy of coronary arteries is mostly based on studies conducted on the western population and quite a few studies report the coronary arterial patterns of Asian population. Between the two main coronary arteries, i.e. the right coronary artery (RCA) and left coronary arteries (LCA), variation in the branching pattern of RCA is more common than LCA. The present study investigated the branching pattern of RCA in the local population in Pakistan and hence will add to the existing data on inter- and intra-population frequencies of branching pattern of RCA among non-Europeans.   Methods:  It was an observational study of six months duration and conducted on dissection cadavers available in various medical colleges of Rawalpindi and Khyber Pakhtunkhwa. The branching pattern of RCA was studied by blunt dissection method.   Results:  Right marginal, conus, Sinuatrial (SA) nodal, atrioventricular (AV) nodal and posterior descending arteries (PDA) were arising from RCA in majority of cases. However, the branching pattern varied from one heart to another as reported in other studies carried out in developed countries. The frequencies of branching patterns of RCA varied from those already reported in literature.  Conclusions:   RCA manifest anatomical variations in branching pattern as reported in international literature and this variation is different in different populations of the world which indicates that postnatal development, along with differences based on geography and ethnicities might contribute to the modification of anatomical pattern of coronary arteries in humans.  
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巴基斯坦人群右冠状动脉分支形态的尸体研究
背景:冠状动脉的起源、路线和分布区域不同是很常见的。对于心脏外科医生和内科医生来说,了解这些变化是非常重要的。然而,这种变异的流行程度在不同的人群中有所不同。现有的关于冠状动脉解剖结构变化的数据主要是基于对西方人群进行的研究,相当多的研究报告了亚洲人群的冠状动脉模式。在两条主要冠状动脉,即右冠状动脉(RCA)和左冠状动脉(LCA)之间,RCA分支模式的变化比LCA更常见。本研究调查了巴基斯坦当地人群中RCA的分支模式,因此将增加关于非欧洲人RCA分支模式的种群间和种群内频率的现有数据。方法:对拉瓦尔品第和开伯尔-普赫图赫瓦省各医学院的解剖尸体进行为期6个月的观察性研究。用钝性解剖法研究了RCA的分支形态。结果:RCA以右边缘、圆锥、窦房结、房室结、后降支为主。然而,在发达国家进行的其他研究报告中,不同心脏的分支模式各不相同。RCA分支模式的频率与文献报道的不同。结论:国际文献报道的RCA在分支模式上存在解剖变异,这种变异在世界不同人群中是不同的,这表明出生后的发育,以及地理和种族的差异可能有助于人类冠状动脉解剖模式的改变。
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