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Origine in sinusul coronar drept, strabate jumatatea dreapta a santului coronar. Traiectul
de ansamblu al ACD este general simetric contralateral cu traiectul ACX realizand
impreuna un cerc frontal. In tipul de dominanta dreapta ACD la nivelul crux cordis se
continua cu ADP si SLP.
Ramurile colaterale sunt:
-Artera conului(participa la inelul lui Vieussens impreuna cu ramurile ventriculare
drepte din ADA)(20-30% din cazuri are origine separata direct din Ao)
- Artera nodului sinusal(55%)
-Artera marginala dreapta(iriga VD si apexul ).
-Artera nodului atrioventricular (iriga NAV).
-Artera descendenta posterioara(iriga 1/3 posteriora a SIV, )
-Sistemul postero-lateral.
In dominanta dreapta ACD iriga: peretele inferior al VS, SIV inferior, NAV, ramul drept
si portiunea posteriora al ramului stang al fasciculului HIS, muschiul papilar postero-
medial.
Angiografic se imparte in 3 segmente:
-Segmentul I (de la origine pana la prima curbura).
-Segmentul II (de la prima curbura pana la a doua curbura)
- Segmentul III (de la cea de-a doua curbura pana la crux cordis)
Principalele incidente angiografice pentru ACD
Anatomia coronariana
Anatomia coronariana in plan atrioventricular si interventricular.
Notiunea de dominanta
Four possible pathways of the anomalous left coronary artery arising from the right coronary sinus (R): A, Interarterial
(between the aorta and the pulmonary artery [PA]); B, retroaortic; C, prepulmonic; and D, septal (beneath the right
ventricular outflow tract). L = left coronary sinus, N = non-coronary sinus.The right coronary artery has a normal origin
from the right coronary sinus (curved arrow) but the left anterior descending artery arises from the right coronary cusp
and courses beneath the pulmonary artery (straight arrow). F, The left anterior descending artery arising from the right
coronary sinus and taking a septal (subpulmonic) course.
Origine a ACS din artera pulmonara(0,002%).
Anomalous origin of the left coronary artery (LCA) from the pulmonary artery. A to C, The thoracic aortogram
shows a large right coronary artery (RCA) and no antegrade filling of the LCA. The LCA fills primarily through
extensive collaterals from the RCA to the LADA (straight arrows). The anomalous origin of the LCA from the
pulmonary artery is demonstrated in late phases of the aortogram (C, curved arrow).
Anomalii de origine a ACX (0,67%)
Anomalous origin of the left circumflex coronary artery from the right coronary sinus.
Artera coronara unica(0,066%).
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