Coronary arteries normally depart from the aorta to form on the surface of the choroid plexus of the heart resembling a crown or a crown. That's why they are called coronary arteries or coronary. The right coronary artery supplies the right heart and the left - the left. Blood flow in these arteries is crucial for the heart.
Abnormalities of development are found in more than 2% of the people. This may be a change in the total number of arteries, the nature of a discharge or a branch. However, more of them has no clinical significance and did not appear during a person's life. Problems arise when the left coronary artery from the aorta is not depart, which is the arterial blood, and from the pulmonary artery that carries venous blood to the lungs with oxygen poor. Then the power of the heart is oxygen-poor blood. In addition, pulmonary artery pressure less than the pressure in the pulmonary artery and the blood supply to the heart suffers an even greater extent.
There are two types of such defect:
Type when the collaterals (blood vessels connecting the branching system of the left and right arteries, blood flow is a workaround) between the systems of the left and right coronary arteries are poorly developed. Then, during a more severe defect. And the type, when collaterals are well developed and the muscle of the left heart can receive oxygen-rich blood under normal pressure of the right coronary artery. Then the patient more than compensated.
In most cases, a manifestation of this evil plight. Fast enough there is heart failure. In the literature this is called a syndrome of Bland-White-Garland.
Anomalies of the coronary arteries - Diagnosis
When listening is often found systolic murmur at the apex, as due to circulatory disorders, changes occur in the mitral valve and mitral insufficiency. An electrocardiogram reveals signs of increased left ventricle, signs of worsening supply the heart muscle, and even signs of scarring of the heart muscle. More precisely, this defect is diagnosed by coronary angiography. With the introduction of contrast material reveals its penetration through the collaterals of the left coronary artery and then into the pulmonary artery.
Treatment of anomalies of the coronary arteries
There are two types of operations. If the collaterals are well developed possible ligation of left coronary artery close to its discharge from the pulmonary artery. Then the blood supply to the heart via the right coronary artery. If the collaterals are poorly developed, produced the reconstruction of left coronary artery through the graft and connect it to the aorta.