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Biomedical subjects

C E Nerantzis

Publications and source records attributed to C E Nerantzis.

10 recordsLinked to original sources
PubMed2000

Ectopic "high" origin of both coronary arteries from the left aortic wall: anatomic and postmortem angiographic findings.

Anatomic and postmortem angiographic findings of a previously unreported case of ectopic origins and unusual courses of the right coronary (RC) artery and the left coronary (LC) artery were demonstrated. This specimen was unique among 450 angiographies and 60 corrosion castings of the human hearts examined in this study. The ostium of the RC artery was pocket-like, located in the left aortic wall at roughly 180 degrees to the long axis of the ascending aorta and 19 mm above the rim of the sinotubular junction (SJ). Initially, the RC runs to the right and downward, passing high in the cleft between the aorta and the pulmonary trunk, thereby avoiding a possible compression from them. The ostium of the LC faced upward and originated from the left aortic wall 7 mm above the SJ. The LC ran to the left and downwards for 16 mm until its division. Histologically, the first 11 mm of the RC were elastic. This observation, together with its high course between the great vessels, combined to make this case benign. The best x-ray projections to show the characteristic findings of the present case were anteroposterior and lateral, which were of practical importance for the correct determination and interpretation of this case. The cardiac surgeon should be aware that high cannulation will be required to locate the RC to avoid accidentally cross-clamping or transecting the vessel during surgery where this anomaly may be encountered.

Adolescent↗
PubMed2000

Ectopic "high" origin of both coronary arteries from the left aortic wall: anatomic and postmortem angiographic findings.

Anatomic and postmortem angiographic findings of a previously unreported case of ectopic origins and unusual courses of the right coronary (RC) artery and the left coronary (LC) artery were demonstrated. This specimen was unique among 450 angiographies and 60 corrosion castings of the human hearts examined in this study. The ostium of the RC artery was pocket-like, located in the left aortic wall at roughly 180 degrees to the long axis of the ascending aorta and 19 mm above the rim of the sinotubular junction (SJ). Initially, the RC runs to the right and downward, passing high in the cleft between the aorta and the pulmonary trunk, thereby avoiding a possible compression from them. The ostium of the LC faced upward and originated from the left aortic wall 7 mm above the SJ. The LC ran to the left and downwards for 16 mm until its division. Histologically, the first 11 mm of the RC were elastic. This observation, together with its high course between the great vessels, combined to make this case benign. The best x-ray projections to show the characteristic findings of the present case were anteroposterior and lateral, which were of practical importance for the correct determination and interpretation of this case. The cardiac surgeon should be aware that high cannulation will be required to locate the RC to avoid accidentally cross-clamping or transecting the vessel during surgery where this anomaly may be encountered.

Adolescent↗
PubMed1998

Variations in the origin and course of the posterior interventricular artery in relation to the crux cordis and the posterior interventricular vein: an anatomical study.

Corrosion castings of 60 human hearts were used to demonstrate that the point of origin of the posterior interventricular artery (PIA), in relation to the crux cordis, is responsible for its subsequent course with respect to the posterior interventricular vein (PIV). In seven cases (12%), the PIA appeared as the continuation of the left circumflex, descending rightwards and on a deeper level of the PIV. In 53 cases (88%), the PIA arose from the right coronary artery (RCA) and 50 of these were selected to be classified into three groups, according to the PIAs origin and course. In group A (29 cases, 58%) and B (seven cases, 14%), the PIA emerged before the crux cordis and descended to the right or left of the PIV, respectively. In group C (14 cases, 28%), it originated at, or beyond, the crux cordis and descended along the left side of the PIV. Among the 50 cases, the PIA was found to be long in 34 (68%), large in 32 (64%), and long and large in 29 cases (58%). In 18 of the latter 29 cases (62%) or 36% of the 50 cases in total, the PIA arose as a continuation of the RCA (group A) and therefore these cases were easily accessible to interventional cardiologists and also to surgeons, since the PIA lay on the same or on a superficial level in relation to the PIV. This work describes and explains the variations of the PIA and concludes that at least 36% of these may be helpful in coronary artery angioplasty and bypass surgery.

Adult↗
PubMed1998

Variant of the left coronary artery with an unusual origin and course: anatomic and postmortem angiographic findings.

This study demonstrates anatomic and postmortem angiographic findings characterizing the origin of the left coronary (LC) artery arising in common trunk with the right coronary (RC) artery from the right aortic sinus and its course via the ventricular septum (VS) to the left heart. This anomaly was a single finding observed among 388 angiographies and 60 corrosion castings. The course of the LC was divided in four segments. The first three form a curve that is upward concave. Large branches to the septomarginal trabecula (ST), VS, diagonals (DS), and the small anterior interventricular (anterior descending) artery originated from the outer part of this curve. In the anteroposterior x-ray, the above curve resembles a deep-bottom pot with a handle corresponding to the fourth segment. In the right anterior oblique, the first and second segments form a large erect angle. The third segment occupies the lower part of the absent proximal anterior interventricular artery, and the fourth crosses the outflow tract and the first segment in the middle. The course of these four segments of LC resembles the shape of the number 6. These findings are important for interpreting coronary angiographies in patients with this anomaly.

Adolescent↗
PubMed1997

Posterior right diagonal artery. An angiographic study.

The purpose of this prospectively performed study was the angiographic visualization of the posterior right diagonal artery (PRDA) and its differentiation from the epicardial branches of the right coronary artery (RCA), that is, the right marginal artery and the posterior descending artery (PDA). The authors prospectively studied the angiographic findings of 607 patients who underwent coronary angiography. The incidence of the angiographically demonstrated PRDA and its distinction from other epicardial branches arising from the distal third of the RCA was the main point of interest. Two types of PDA in those cases where PRDA was present were also demonstrated. Of the patients examined, 535 had dominant right coronary circulation, 59 had left dominant coronary circulation, and 13 had balanced coronary circulation. PRDA was present in 81 patients with right dominant coronary circulation (15.1%), in 2 patients with balanced coronary circulation (15.4%), and in none with left dominant coronary circulation. PRDA was revealed in 48 (40%) of 120 patients with a short PDA and in only 33 (8%) of 415 patients having long PDA. It is imperative to search always for the PRDA, when one is studying coronary arteriographies, bearing in mind that this artery may perfuse the inferior part of the posterior interventricular septum and the adjoining are, depending on the type of PDA.

Coronary Angiography↗
PubMed1996

Functional dominance of the right coronary artery: incidence in the human heart.

After injection of radiopaque medium, 200 human hearts were studied by direct observation and x-ray analysis. The right coronary artery (RC) was dominant in 178 of these hearts as characterized by giving off the typical posterior interventricular artery (PIV), the posterior descending artery. Within this group, 19 specimens had right coronary arteries that gave off both a large posterior interventricular artery (LPIV) and a branch that continued beyond the crux termed a large extension of the right coronary (LERC). The subgroup of hearts supplied thusly was termed real right dominant (RRD). The RC in these hearts supplied the right ventricle and almost half of the left ventricle. These findings explain why proximal lesions of the RC in RRD hearts can be associated with extensive posterolateral ischemia and mitral dysfunction and should be of practical importance when considering angioplasty or by-pass surgery. The diameters and lengths of the arteries of the RC in RRD hearts were measured and compared with the same parameters in typical right dominant hearts.

Adult↗
PubMed1994

Posterior right diagonal artery.

BACKGROUND: There is general confusion about a branch of the posterior segment of the right coronary artery that has been referred to as 1) the lower trunk of a divided right coronary artery; 2) a posterior reflection of the right marginal artery; 3) the ramus lateralis; and 4) a posterolateral branch or a posterior descending artery. MATERIALS: Three hundred human hearts were studied by direct observation, X-ray films, and corrosion casting. RESULTS: This branch of the right coronary artery arises either after the right marginal artery (in 84% of hearts) or it constitutes the continuation of this artery in the remaining 16%. We named it the posterior right diagonal artery (PRDA). It was found in 14% of 266 hearts of right dominant type. It was present in 39% when the length of the posterior descending artery (PDA) was shorter than half of the length of the posterior interventricular sulcus (PIS) and in 6% when it was longer. When the PRDA originated directly from the RCA, the RMA appeared underdeveloped; the PRDA always occupied the inferior part of the PIS and appears either as continuation of a short PDA or as a replacement for a long PDA from the point where this artery leaves the PIS to enter the posterior wall of the left ventricle. The PDRA when present serves as a bridge between the RCA and the left anterior descending artery. CONCLUSIONS: These findings are of practical importance for the correct interpretation of coronary arteriographies and in the field of coronary artery surgery.

Adolescent↗
PubMed1983

The importance of the sinus node artery in the blood supply of the atrial myocardium. An anatomical study of 360 cases.

The sinus node artery (SNA) and its contribution to the blood supply of the atrial myocardium (AM) were studied using X-rays and corrosion casting in a series of 360 human hearts. In 68 cases (19%) the SNA supplied the right atrium and part of the atrial septum (group A), in 211 cases (59%) it supplied the myocardium of one atrium (right or left), the atrial septum and part of the other atrium (group B), and in 81 cases (22%) the SNA supplied almost the entire AM (group C). In 133 cases (37%) the vessel supplying the sinus node (SN) was not the main continuation of the SNA, contrary to what is generally accepted. The SNA has many intercoronary and intracoronary anastomoses which comprise an important anastomosing net between the right coronary (RC) and left circumflex (LCir) arteries. These findings suggest that the SNA plays a major role in the blood supply of the AM apart from the SN.

Coronary Circulation↗