BRANCHING PATTERN OF THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN A BLACK KENYAN POPULATION

Citation:
Ogeng’o JA, Misiani MK, Olabu BO, Waisiko BM, Murunga A. "BRANCHING PATTERN OF THE LEFT ANTERIOR DESCENDING CORONARY ARTERY IN A BLACK KENYAN POPULATION." Anatomy Journal of Africa . 2016;5(2):755-763.

Abstract:

Branching pattern of the left anterior descending coronary artery is important in explaining variations in
occurrence of coronary atherosclerosis, informing management strategies for coronary heart disease and
interventional cardiology. Data on African populations are, however, scarce. Since coronary heart disease
is increasing in Africa, the aim of this study was to describe branching pattern of the left anterior
descending coronary artery in an indigenous Kenyan population. Two hundred and eight hearts obtained
during autopsy were dissected at the Department of Human Anatomy, University of Nairobi, Kenya. The
entire left anterior descending coronary artery was exposed. Number of branches, pattern of termination
and level of bifurcation were determined. Images of representative patterns were taken using a high
resolution digital camera. Data are presented in macrographs and tables. The number of septal and
diagonal branches varied between 1 and 3. Termination occurred in the posterior interventricular sulcus
in 68.8% and at the apex in 23% cases. Most common mode of terminal branching was bifurcation
(76.9%) followed by trifurcation (11.3%), quadrifurcation (3.4%) and pentafurcation (1.5%). Bifurcation
occurred in the distal segment in 48.8% and in the proximal segment in 15% of cases. The left anterior
descending coronary artery displays high variability in number of septal and diagonal branches, level of
termination, mode of terminal branching and level of terminal bifurcation. These patterns may constitute
risk factors for atherosclerosis and should also be acknowledged during cardiac procedures. Pre –
operative ultrasound evaluation is recommended to minimize inadvertent iatrogenic injury.

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