Coronary artery variations and median artery in Turkish cadaver hearts

Fazliogullari Z, Karabulut AK, Unver Dogan N, Uysal II
Correspondence: Dr Nadire Unver Dogan, nunver2003@yahoo.com

ABSTRACT
Introduction This study examined the routes and variations of the left coronary artery (LCA), the right coronary artery (RCA), and their branches, as well as the frequency of a median artery in cadaver hearts.
Methods The hearts of 50 adult Turkish cadavers from various centres were dissected.
Results The LCAs branched out of the aortic sinus and had an average diameter of 4.44 +/- 1.79 mm. They gave rise to two branches (bifurcation) in 46 percent, three branches (trifurcation) in 44 percent and four branches (quadrifurcation) in ten percent of the hearts. The median artery was identified in 27 hearts, with a mean diameter of 2.00 mm (standard deviation 0.67). The RCAs branched out from the right aortic sinus and had an average diameter of 3.32 +/- 0.79 mm. The conus branch, classically known as a branch of the RCA, branched out from the RCA in 32 percent of the hearts and from the right aortic sinus in 68 percent. Right dominance was observed in 42 percent, left dominance in 14 percent, and equal dominance in 44 percent of the hearts. Myocardial bridges were found on the LCA branches in 22 of the 27 hearts in which the median artery existed.
Conclusion There is a close relationship between the existence of the median artery and myocardial bridges. This suggests that the median artery might be important in myocardial bridges, which exist in embryos but do not result in any clinical symptoms for many years in a large number of people.

Keywords: left coronary artery, median artery, myocardial bridge, right coronary artery
Singapore Med J 2010; 51(10): 775-780