Collateral Circulation in Human Heart

Abstract

The aim of the investigations was to demonstrate different types of collaterals of coronary arteries using the method of coronary angiography and injection-corrosion method. The investigations were carried out on 30 human cadaveric hearts from the Department of Anatomy, and 30 angiograms of patients from the Cardiology Department of Clinics Centre in Sarajevo. Clinical investigations were retrospective and prospective on patients that were treated in hospital, and on patients that just arrived in hospital (based on findings of coronary angiography). The results show the existence of different types of collaterals: intercoronary and intra-coronary. We established collaterals in a case with occlusion of the right coronary artery and left coronary artery in which better development of collaterals was established. Our patients were classified in two groups:

1) Patients with good collaterals and good left ventricular function;

2) Patients with good collaterals and impaired left ventricular function. On the anatomical material, we found different types of collaterals as well.

Our results show that coronary angiography is a useful diagnostic method for the demonstration of coronary collaterals.

The collaterals of human coronary arteries have always attracted the attention of anatomists, pathologists, surgeons, as well as experts in many clinical disciplines. The occurrence of coronary diseases has increased recently so much that it stimulates researchers to become acquainted with collaterals of coronary arteries. Its real significance is expressive in cases with occlusion or stenosis of coronary arteries -angina, myocardial infarction, congenital cardiovascular malformations. Therefore, the aim of the investigations was to demonstrate different types of collaterals of the coronary arteries in normal conditions and the conditions of the coronary disease using the method of coronary angiography and injection corrosion method. On the other side, these investigations are important because of contrast opinions that are given in literature concerning coronary arteries collaterals. According to some authors, collaterals exist and they are functional. The others think that collaterals exist, but that they are insufficient for collateral circulation and only develop in pathological conditions.