Third branch derived from left coronary artery: the median artery

Abstract

Our purpose was to describe the number and trajectory of terminal branches of main trunk of left coronary artery in the Turkish cadavers. Our study was conducted on 50 hearts from adult cadavers, and the numbers of branches of main trunk of the left coronary artery were analyzed. We refer to "the median artery" as the artery deriving from the main trunk in addition to two terminal branches originating from the left coronary artery, and "r.lateralis" (r.diagonalis) as branches originating from a.interventricularis anterior. The most frequent type of division of the main trunk of left coronary artery was bifurcation (86%), in 14% of the cases the main trunk of left coronary artery divided into three branches (trifurcation), and a.mediana was detected in 7 hearts. In addition, the diagonal branches derived from a.interventricularis anterior were seen in 49 of the 50 hearts. Sufficient knowledge about the anatomy and variations of coronary arteries is important for proper interpretation of the coronary angiographies and assessment of the findings of coronary insufficiency such as surgical myocardial revascularization. The patient, thus, may have a heart attack in case of an atherosclerotic obstruction of the branches of left coronary artery supplying the majority of blood support of the heart. Distal obstruction of the other branches of a.mediana deriving from the main truncus may have a protective effect against a heart attack.