Overview of Cardiac, Valvular and Coronary

Anatomy

Vijay Kunadian MBBS, MD, FRCP, FACC, FESC, PG Dip Clinical Trials
Institute of Cellular Medicine, Faculty of Medical Sciences, Newcastle University
&
Freeman Hospital, Newcastle upon Tyne, United Kingdom
Disclosure Statement of Financial Interest

I, Vijay Kunadian do not have any

disclosures relating to this presentation.
UK Interventional Procedures 2016

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200000

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3250
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Angiography PCI TAVI
Procedures
UK Interventional Procedures 2016

900 827
800
700 603
600
500 478
400 310
300
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Procedures
Cardiac Anatomy
 Cardiac Anatomy

Aorta

Pulmonary
artery
Left anterior
descending artery
Left Ventricle
University of Glasgow

Think of the unseen…

With permission: Anatomy and clinical skills, Newcastle

University
 Cardiac Anatomy

Aorta
Right Coronary artery

Right atrium
AV Branch
Right ventricle
Atrio-ventricular
groove

With permission: Anatomy and clinical skills, Newcastle University

 Coronary Ostia
With permission: Anatomy and clinical skills, Newcastle University

Left main stem

Left coronary ostia

Aorta
Left ventricle
Right coronary
sinus

Right coronary
ostia
Coronary Artery Origins

Newby et al. N Engl J Med 2018; 379:924-933

Coronary Anatomy

Left Main or left coronary artery (LCA)

Left anterior descending (LAD), diagonal
branches (D1, D2), septal branches

LMS
LAD
D1
Septal
D2
Right Coronary Artery

Marginal
branch Conus
RCA branch
PLV

INF

PDA

AM

Marginal
branch

Radiographics 2007;27:1569-1582
 Circumflex Artery
On the left an overview of the
coronary arteries in the lateral
projection.

Circumflex (Cx)
Marginal branches (OM1, OM2)
LMS CX
OM

CX LAD
OM1
OM
CX
OM2

OM
Coronary Artery Anomalies
Myocardial Bridge

Left main stem

arising from the
RCS

The prevalence of MB has a wide range from 0.15%-25%

angiographically, to between 5% and 86% at autopsy
 Coronary Artery Anomalies
RCA Atresia Double LAD

LMS Atresia

Villa et al. World J Radiol 2016 June 28; 8(6): 537-555

Aortic valve

Siontis et al. Eur Heart J. 2016;37(47):3503-3512

Mitral valve

A B C

Death from any cause or

unplanned
hospitalization for heart
failure at 12 months.

Obadia et al. NEJM 2018

 Tricuspid valve

Grasso et al. EuroIntervention 2018;14:AB112-AB120

Pulmonary valve
 Other cardiac anatomy

Left atrial
appendage

Septal defects
 Conclusion
• Knowledge of cardiac, valvular and coronary
anatomy and anomalies are critical in
interventional cardiology in the management
of patients with heart disease

“Success is neither magical nor mysterious.

Success is the natural consequence of
consistently applying the basic fundamentals”

-Jim Rohn