Sharing and caring for others is the unique human nature . Some believe this is now gradually becoming rare in human domain , but still found in plenty among animal species. While modern human likes to live independently wants to stand on his own legs our biological system still think differently .
A 40-year-old man with diabetes and hypertension with class 3 angina had this angiogram
RCA to LAD collaterals
A different view
RCA to LAD in RAO caudal view
See , how a pair of human coronary arteries mutually help their colleague at times of distress !
The astonishing observation is , the RCA even as its suffering with a severe, long segment disease it helps out-of-the-way , with a long arm of support to the entire LAD . While , the LCX reciprocates the RCA by sending thank you twigs to distal RCA
LCX sending reciprocating twigs to RCA
By the way , this patient was referred for CABG after an intense debate in the cath meeting .The argument ranged from medical management /PCI/CABG.
The key question were
- How good is the collateral’s and what are the chances of graft flow exceeding the collateral blood flow ?
- What is the effect of CABG on the existing collateral’s ?
Final message
Coronary arteries has unique sense of sharing and friendship at times of vascular crises.
This is the fundamental basis for coronary collateral circulation .
Dr.S.Venkatesan MD 