Left anterior descending artery length in left and right coronary artery dominance

Background Coronary stenosis of the left anterior descending artery (LAD) i s respected by cardiologists because of its negative influence on morbidity and mortality. An important anatomical consideration is the length of the LAD. Objective To investigate the relationship between length of LAD and coronar y dominance. Design Retrospective comparison of 100 consecutive angiograms with left cor onary dominance with 100 consecutive angiograms with right coronary dominan ce. The relationship between the length of the LAD and coronary dominance w as analyzed. Methods We retrospectively compared 100 consecutive angiograms with left co ronary dominance (the posterior descending artery being supplied by the cir cumflex artery) with 100 consecutive angiograms with right coronary dominan ce (the posterior descending artery being supplied by the right coronary ar tery). LADs were categorized into three types: type A, LAD terminating befo re the cardiac apex; type B, LAD reaching the apex but not supplying the in feroapical segment of the left ventricle; and type C, LAD wrapping around t he apex and supplying the inferoapical segment. LAD typing was also analyze d in relation to gender. Results It was found that the LAD wrapped around the apex in 87% of cases o f left coronary dominance but only in 47% of patients with right coronary d ominance, and that the long LADs were more frequently seen in women than in men, irrespective of coronary dominance. Conclusions We found that the LAD in left coronary dominance is usually lon g and wraps around the apex, and believe that angiographic interventions in such cases have important clinical significance. Coron Artery Dis 12:77-78 (C) 2001 Lippincott Williams & Wilkins.