LAD coronary artery

In Fig. 2.2, the PET perfusion images show severe stenosis or occlusion of the left circumflex (LCx) and right (RCA) coronary arteries with a moderately severe stenosis of the left anterior descending (LAD) coronary artery proximal to its second diagonal branch. The ejection fraction (EF) and regional LV contraction were normal. Therefore, this example illustrates purely ischemic myocardium without scar and without injured or poorly contracting myocardium. 

Figure 3.3 Left Recordings in case of experimental occlusion of LAD coronary artery in a dog with open heart. (A) Control. (B) ECG pattern of ischaemia (negative T wave). (C) ECG pattern of injury (ST-segment elevation).

Using this model, calculations which predict waveform development in the coronary system can be carried out for both animals and man. One such case is shown here, and as was seen, the pressure waveform is predicted to develop low-frequency oscillations as it propagates down the left main and the LAD coronary arteries. This is exactly as observed experimentally by Rumberger et al. (1979). 

Two-vessel coronary artery disease (60% right coronary artery [RCA] and 80% left anterior descending artery [LAD] occlusion) after intracoronary CYPHER stent placement to the mid-LAD artery lesion 10 months ago. 

Abbreviations AMI, acute myocardial infarction LAD, left anterior descending LCX, left circumflex LMCA, left main coronary artery RCA, right coronary artery pt, patient. 

Abbreviations BMS. bare metal stent LAD. left anterior descending artery LCX, left circumflex coronary artery LM. left main MVD. multiple vessel disease RCA. right coronary artery. 

The first phase I clinical trial of coronary angiogenesis demonstrated the safety of intramyocardial injection of 0.01 mg/kg of FGF-I (79), A total of 40 patients undergoing CABG of the internal mammary artery (IMA) to left anterior descending coronary artery (LAD) were randomized to receive intramyocardial injections of either 0,01 mg FGF-1 or placebo. All the patients had further stenoses of the LAD distal to the anastomosis, Coronary angiography 12 weeks after treatment showed increased capillary refill in patients... 

I/R = ischemia/reperfusion CA = coronary artery LV = left ventricle MI = myocardial infarction and LAD = left anterior descending branch of left coronary artery. 

The myocardium and specific conduction system (SCS) are perfused by the right coronary artery (RCA), the left anterior descending coronary artery (LAD) and the circumflex coronary artery (LCX). Figure 1.1 shows the great correlation of coronary angiography and CMDCT in normal coronary tree and some pathologic cases. 

Figure 1.14 According to the anatomical variants of coronary circulation, there are areas of shared variable perfusion (A). The perfusion of these segments by the corresponding coronary arteries (B—D) can be seen in the bull s-eye images. For example, the apex (segment 17) is usually perfused by the LAD but sometimes by the RCA or even the LCX. Segments 3 and 9 are shared by LAD and RCA, and also small part of mid-low lateral wall is shared by LAD and LCX. Segments 4, 10 and 15 depend on the...

RCA or the LCX, depending on which of them is dominant (the RCA in >80% of the cases). Segment 15 often receives blood from LAD. (E) Correspondence of ECG leads with the bull s-eye image. Abbreviations LAD, left anterior descending coronary artery SI first septal branch D1 first diagonal branch RCA, right coronary artery PD, posterior descending coronary artery PL, posterolateral branch ... 

Both acute coronary syndromes (ACSs) and infarcts in chronic phase affect, as a result of the occlusion of the corresponding coronary artery, one part of the two zones into which the heart can be divided (Figure 1.14A) (1) the inferolateral zone, which encompasses all the inferior wall, a portion of the inferior part of the septum and most of the lateral wall (occlusion of the RCA or the LCX) (2) the anteroseptal zone, which comprises the anterior wall, the anterior part of the septum and often a great part of inferior septum and part of the mid-lower anterior portion of lateral wall (occlusion of the LAD). In general, the LAD, if it is large, as is seen in over 80% of cases, tends to perfuse not only the apex but also part of the inferior wall (Figures 1.1 and 1.14). 

Figure 4.10 In an acute coronary syndrome with ST-segment elevation in V1-V2 to V4-V6 as the most striking pattern, the occluded artery is the left anterior descending coronary artery (LAD). The correlation of the ST-segment elevation in V1-V2 to V4-V5 with the ST morphology in II, III and VF allows us to know if it is an occlusion proximal or distal to D1 (see Figure 4.43). If it is proximal, the involved muscular mass in the anterior wall is large and the injury vector is directed not only forward but also upward, even though there can be a certain...

LAD, left anterior descending RV, right ventricle LCX, circumflex artery RCA, right coronary artery LV, left ventricle. See algorithm in Figure 4.43. f See algorithm Figure 4.45. 

Therefore, in chronic patients it is impossible to know the exact degree of occlusion of the coronary artery culprit of ACS in this moment, although, probably, it can be predicted what the type and location of the occlusion that produced the MI were. For example, a case of proximal occlusion to D1 and SI of LAD (Figure 2.3A) after treatment presented an ECG of non-complete occlusion of LAD, encompassing the septal branches, but not the diagonal... 

This is an anomaly of the course of the coronary arteries, especially the LAD, which partly penetrates epicardial muscular mass. It is frequently, though... 

Abbreviations PCI = primary coronary intervention ECG = electrocardiogram LAD = left anterior descending coronary artery CAD = coronary artery disease LV = left ventricular CABG = coronary artery bypass grafting. 

A segment of the left anterior descending coronary artery (LAD), approximately two-thirds the distance from apex to base, is isolated and a silk ligature is placed around the segment. 

A EXPERIMENTAL FIGURE 18-21 Atherosclerosis narrows and blocks blood flow through coronary arteries. X-ray multislice computed tomographic image of a human heart reveals a major occlusion (black arrow) of the left anterior descending artery (LAD, arrow) and a narrowing of a nearby vessel (white arrow) as a block in the stream of blood (seen in the arteries as a white tube). [From K. Nieman et al., 2001, Lancet 357 599.]... 

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