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.