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Posts Tagged ‘premature branching of LCX from left main’

Left main bifurcates into two , that’s  the classical anatomical behavior of LCA. (Or it trifurcates) When left main divides , it tends to share its diameter between its two siblings LAD and LCX with considerable  whims and fancies.(Though Finet* et all thought it has a working rule !) * From  Biomedical Engineering, Cardiovascular Hospital and Claude Bernard University France

Now , have a look at this , its a rare example of  how a left main might Ignore the rule of bifurcation just like that !

Left main simply continues as left main* after giving off a casual side branch from mid left main shaft .Yes , Its a innocuous looking LCX which would be non dominant as expected

LCX arises exactly mid way in left main , (Technically LAD begins at this point ) but , can you find any difference in the left main after giving off  LCX branch.

Can we say left main continues as LAD without a bifurcation ?

Or shall we say  left main gives off a premature early side branch ( true LCX)  non bifurcating  branch ?

It is an unusual anatomy and  as expected , this patient had a dominant  RCA .

What could be the clinical implication for such a premature  LCX ?

We can only guess . May be nothing !  Obviously ,these patients are immune to develop true bifurcation lesion. Does it in any way mean they have anatomically blessed coronaries !

 

Reference 

1.Finet G1, Gilard M, Perrenot B Fractal geometry of arterial coronary bifurcations: a quantitative coronary angiography and intravascular ultrasound analysis. , EuroIntervention. 2008 Jan;3(4):490-8.
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