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Chest imaging
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
o The vessel that supplies the posterior descending artery to the inferior surface of the heart is called dominant. There is usually right dominance, i.e. the right coronary artery supplies the inferior heart/posterior descending artery. The right coronary may be small when the left cir-cumflex supplies the inferior heart, called left dominance (Fig. 3.56).
Recent advances in multimodality imaging of the tricuspid valve
Published in Expert Review of Medical Devices, 2021
Sergio Caravita, Stefano Figliozzi, Diana-Ruxandra Florescu, Valentina Volpato, Giorgio Oliverio, Michele Tomaselli, Camilla Torlasco, Giuseppe Muscogiuri, Franco Cernigliaro, Gianfranco Parati, Luigi Badano, Denisa Muraru
The TA is a saddle-shaped dynamic structure (Figure 2), between the leaflets on one side and the atrial and ventricular myocardium on the other side [19,20]. The TA is a virtual structure, largely composed of adipose tissue, with a smaller amount of fibrotic tissue [20,21]. This allows the geometry and dimensions of the annulus to change significantly during the cardiac cycle (rounder and larger during diastole; more elliptical and ~20% smaller in circumference during systole), but at the same time predisposes it to dilate under pathological conditions. The atrioventricular node is located superiorly to the anteroseptal portion of the TA and continues caudally with the His bundle that is in a close spatial relation with the anteroseptal portion of the TA. Therefore, any compression at this level may cause a complete atrioventricular block and, in the case of a permanent injury, the need for permanent pacemaker implantation [19]. Another critical structure close to the TA is the right coronary artery. The course of the right coronary artery and of the branches of the coronary veins within the atrioventricular groove are initially relatively distant from the TA. However, toward the inferior segment of the annulus, the distance between these two structures gradually shortens (<3 mm). In particular, the right coronary artery runs generally closer to the anterior leaflet insertion (~2 mm) than the posterior tricuspid leaflet insertion (median distance ~7 mm) [22].
A computational fluid dynamics study pre- and post-fistula closure in a coronary artery fistula
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2020
Haoyao Cao, Yue Qiu, Ding Yuan, Jianqun Yu, Da Li, Yi Jiang, Li Su, Liqing Peng, Tinghui Zheng
The patient-specific three-dimensional anatomical model including coronary tree and the aortic root was reconstructed from CTA using an open source SimVascular software package (SimTK) (Updegrove et al., 2017) and the post-treated CAF model was obtained to occlude the fistula terminal directly (Figure 2). As it shown that the fistula of this particular CAF is the major branch of the right coronary artery (RCA) and enters the right ventricle instead of myocardium. Due to the accuracy of the CTA, only one minor branch originating from the fistula was remained in the computational model. The diameter of the fistula varies from 11.5 mm at its proximal entrance to 29.8 mm at its distal terminal, and its total length is 303.0 mm. In addition, the fistula is torturous. Four obvious bends or twists are observed, among which the first, second and fourth bends are sharp.
Numerical study of multivessel coronary plaque hemodynamics
Published in International Journal for Computational Methods in Engineering Science and Mechanics, 2019
Hossein Mohammadi, Raymond Cartier, Gilles Soulez, Rosaire Mongrain
Medical imaging techniques have limited capability to perform functional assessment of the coronary plaques. Accordingly, in order to improve the understanding of the formation and development of plaques, numerical methods has been widely used to study blood flow characteristics through the coronary arteries over the last few years [11]–[14]. Only few studies have investigated the dynamics of coronary lesions by mainly considering the impact of plaque severity on hemodynamic conditions using regional computational fluid dynamics (CFD) models of coronary arteries, i.e., either the left coronary artery or the right coronary artery [11], [15], and [16]. It is hypothesized that configuration of coronary lesions plays a key role in haemodynamic interactions between stenoses and could be the main determinant of the lesion physiological severity. We have recently developed a 3D fluid–structure interaction (FSI) model of the aortic valve region incorporating anatomically inspired small coronary vessels and investigated the association between the aortic valve impairment and abnormal coronary hemodynamic conditions [17]–[19]. In the current study, this computational model is employed to investigate the potential intricate hemodynamic interactions between multiple coronary lesions and assess the functional impact of different coronary multilesional configurations as a function of lesion severity.