STUDY OF CORONARY ARTERY ANATOMY AND ITS VARIATIONS USING CORONARY ANGIOGRAPHY AND CADAVERIC DISSECTION

Abstract

 Background: Coronary artery anatomy had played a pivotal role in determining myocardial perfusion and
cardiac function. A detailed understanding of coronary artery morphology and its variations had been
essential for cardiologists, radiologists, and cardiac surgeons to ensure safe and effective interventions.
Coronary artery anomalies, though relatively uncommon, had been clinically significant as they often
predisposed individuals to ischemic heart disease, arrhythmias, or sudden cardiac death. With the advent of
coronary angiography and anatomical dissection techniques, the study of coronary anatomy had become
more refined, allowing for a comprehensive assessment of normal and variant patterns. The current study had
been designed to correlate angiographic findings with cadaveric dissections to provide a detailed overview of
coronary arterial distribution, dominance, and anomalies in the local population.
Aim: The primary aim of this study had been to analyze the anatomy and variations of coronary arteries
using both coronary angiography and cadaveric dissection. It also aimed to identify the prevalence of
coronary dominance patterns and anatomical variations to aid in clinical, diagnostic, and surgical decisionmaking.
Methods: This descriptive cross-sectional study had been conducted at Allied Hospital, Faisalabad, from
August 2024 to July 2025, with a study population of 130 subjects. The participants included 100 patients
who had undergone coronary angiography for diagnostic purposes and 30 preserved human cadaveric hearts
obtained from the Anatomy Department. The angiographic group had included adults of both genders aged
between 30 and 75 years, while cadavers with structurally preserved hearts had been selected for dissection.
Exclusion criteria had included patients with previous cardiac surgery, congenital heart disease, or poor
angiographic visualization.
Coronary angiography had been performed using standard Judkins technique under digital subtraction
angiography (DSA). The origin, course, branching pattern, and dominance of coronary arteries had been
evaluated. For the cadaveric study, careful dissection of the coronary arteries had been performed to visualize
the right and left coronary arteries, their branches, and their dominance. The parameters studied had included
coronary dominance (right, left, or balanced), variations in the origin of the main coronary arteries, presence
of accessory branches, and anomalies such as myocardial bridging or ectopic origin. Data had been recorded,
tabulated, and statistically analyzed to determine the frequency and correlation of findings between
angiographic and cadaveric observations.
Results: The angiographic evaluation had shown that right coronary dominance was the most common
pattern, observed in 78% of the cases, followed by left dominance in 16%, and co-dominance in 6%.
Cadaveric dissections had demonstrated similar findings, with right dominance seen in 80%, left dominance
in 13.3%, and co-dominance in 6.7% of specimens. Variations in the origin of the left circumflex artery 

 arising from the right coronary sinus had been noted in 4% of angiographic cases and 3.3% of cadaveric
specimens. Myocardial bridging, most commonly affecting the left anterior descending (LAD) artery, had
been observed in 9% of angiographic cases and 10% of cadaveric hearts. A strong correlation had been found
between angiographic and cadaveric observations (p < 0.05), confirming the reliability of both techniques in
delineating coronary anatomy.
Conclusion: The study had concluded that right coronary dominance was the predominant pattern in the
population studied, with significant but rare variations in origin and course of the coronary arteries. The
results had confirmed that coronary angiography provided an accurate and minimally invasive method to
study coronary anatomy, while cadaveric dissection remained indispensable for detailed morphological
verification. Understanding these anatomical variations had been crucial for improving diagnostic accuracy,
guiding interventional procedures, and minimizing intraoperative complications.