Introduction
Main coronary arteries show a behavior of proceeding subepicardial on
the surface of the heart and get into the myocardium almost at the
termination part.[1,2] However, in some cases it may become possible
to observe the coronary arteries proceeding intramyocardially even in
proximal and mid parts or all the course.[3,4]
Intramyocardial coronary arteries have always been a challenging
situation for the cardiac surgeons during coronary artery bypass
grafting (CABG) surgery due to the difficulties of targeting distal
anastomosis area leading to inadequate coronary revascularization and
intraoperative complications such as extended bypass time, a prolonged
ischemic interval, ventricular and coronary arterial injuries resulting
with intraoperative bleeding. [1,5-7]
Coronary artery angiography (CAG) is the gold-standard diagnosing
technique for coronary artery diseases (CAD). [1,3-5] Sometimes
typical images of the coronary arteries would suggest a typical anatomic
variation. Thus, a “wide-U” image of left anterior descending artery
(LAD) especially in right anterior oblique position would refer an
intramyocardial location.
In this research, we aimed to define the correlation between the typical
image of LAD in CAG and intraoperative observation of LAD course. In the
literature, there are many samples of researches made on intramyocardial
course of LAD and possible complications following surgery. However, our
research is the first to study the sensitivity and specificity of CAG.