An Angiographic Study of the Left Coronary Artery in the Sudanese Population

Abstract

Abstract

Background: Anatomical variations in the coronary arteries' orifices, courses, branching patterns, and anomalies may have an impact on blood flow. These vessels have hemodynamic characteristics, clinical symptoms, and may be at risk for atherosclerosis. Objectives: This study aims to identify the normal anatomy and common pattern of variation of the left coronary artery and its common branches regarding the origin, course, and termination. To identify the most common sites of coronary artery occlusion in the left coronary artery. Subject and Method: This was a retrospective study conducted during the period from January 2022 to October 2022, with 100 Sudanese patients who underwent conventional coronary angiography at Ahmed Gasim cardiac center and data collected from patients' reports then analyzed with IBM SPSS statistical analysis program version 29. Result: The study group was represented as genders, age group, variable indication of catheterization and site of occlusion percentages.  Findings showed that there is a male predominance upon study samples, and majority of study samples were elderly patients who developed ischemic heart disease. In all samples (100%), the left coronary artery originates from the left coronary sinus; 98% of left coronary arteries bifurcating into left anterior descending and left circumflex branch and 2% of arteries bifurcated into the left anterior descending, left circumflex and ramus intermedius branches. Furthermore, there was variation in the branches of the left anterior descending artery which divided into two diagonal branches in 46% of samples. At 55% of samples, the left circumflex artery gives rise to one obtuse marginal branch, and two branches in 39%. In 21% of samples, the left anterior descending artery is the most occluded artery. Conclusion: This study concluded that there is a considerable anatomical variation in the number of diagonal and obtuse marginal branches arising from the left circumflex artery among Sudanese patients. Ramus intermedius was the most common anatomical variation affecting the left coronary artery.

Keywords: Heart, Left coronary artery, Ischemic heart disease, Ramus intermedius artery, coronary angiography