I hope you are doing well this lovely Tuesday morning. I wanted to shift gears a little bit from aortas this week because we will be getting LOTS of Aorta Education in September :)
While we know that the heart is important for pumping healthy blood to the rest of the body, it is sometimes forgotten that the heart needs blood too to function!! The coronary arteries are the main blood vessels that feed oxygen-rich blood to the heart itself.
Two main coronary arteries come off the aortic root and split into opposite directions:
The first is the right coronary artery which supplies the right side of the heart. In many people it gives off many small branches including the SA nodal artery (which helps feed the electrical system of the heart) and the posterior descending artery in most people, which travels on the posterior (back-side) of the heart muscle.
The second major artery the left main coronary artery- comes off the left side of the aortic root and splits into two large arteries: the left anterior descending artery and the left circumflex artery (LCX).
The LCX loops around the left lateral side of the heart giving off several smaller “obtuse marginal branches.” In some people - the LCx is the one that gives off the posterior descending artery (instead of the RCA).
The left anterior descending artery (LAD) is a crucial artery as it is the main supplier of the left ventricle of the heart - which is the one that directly pumps oxygen rich blood to the rest of the body. It extends all the way down to the “apex” or most distal part of the heart muscle and is the most common artery blocked when someone has a heart attack. The main branches that comes off the LAD include septal perforator branches, and diagonal (D1, D2...) branches.
It is worth nothing that when being evaluated for any kind of cardiac surgery (including aortic surgery), your heart team may request a cardiac catheterization to look at your coronary anatomy. This is because there may be coronary blockages in your heart that can be addressed in addition to your original problem at the time of surgery.
A cardiac catheterization is a special type of imaging that uses contrast dye to evaluate what the inside of your blood vessels look like (in this case the coronary arteries):
And that’s all for this week! We hope you found this brief overview of coronary anatomy helpful. See you all soon for a month of daily posts for Aortic Disease Awareness Month! Until then, stay happy. Stay beautiful. And stay Thinking Aorta :)
-Adham
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