OBJECTIVE: The objective of the present report was to describe the lateral, diagonal and anterosuperior arterial branches in the epicardial adipose tissue of the left ventricle and to analyze their frequency and diameters according to the type of coronary circulation. The precious knowledge of these branches has surgical application in their revascularization or during the injection of the cardioplegic substances into these branches. METHOD: Fifty hearts obtained at autopsy from adult cadavers were dissected and fixed in formalin and the left ventricle was divided into three thirds: superior, middle and inferior. The lateral branch originated from the circumflex branch, the diagonal branch from the division of the left coronary artery and the anterosuperior branch from the anterior interventricular branch in the superior third of the left ventricle. The length in the epicardium and the diameter of each branch were measured and the blood flow was correlated to the type of coronary circulation. RESULTS: The diameter of the lateral branch, present in 88% of the cases, ranged from 0.6 to 4.5 mm (mean: 2.1 ± 0.7 mm). The diameter of the diagonal branch, present in 50% of cases, ranged from 1.0 to 3.8 mm (mean: 2.2 ± 0.7 mm). The diameter of the anterosuperior branch, present in 84% of cases, ranged from 1.0 to 4.1 mm (mean: 2.5 ± 0.8 mm). We detected 30/50 (60%) cases of dominance of the right coronary artery, 14/50 (28%) cases of the balanced type, and 6/12 (12%) cases of dominance of the left coronary artery. Mean blood flow in the anterosuperior branch presented a decreasing value in the following order: dominance of the right coronary artery, balanced and dominance of the left coronary artery. Inversely, the lateral branch presented with increasing values, while the diagonal branch presented a greater flow in the balanced type. CONCLUSION: The results demonstrated the complementarity of the lateral, diagonal and anterosuperior arterial branches, as well as the correlation among these branches with the different types of coronary circulation: right dominance, balanced and left dominance.
Heart; Coronary circulation
