Lviv clinical bulletin 2016, 4(16): 55-58

https://doi.org/10.25040/lkv2016.04.055

Coronary Artery Anomalies: the Efficiency in Diagnosis by the Improved Method in Autopsy Material

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O. Boiko, E. Maksymchuk

Danylo Halytsky Lviv National Medical University

Introduction. Coronary arteries anomalies can only be found during the pathomorphololgical detailed study because clinical symptoms are often absent. The coronary artery anomalies are classified as anomalies of origination, course, quantity, permeability and communication. However, these variants of coronary artery anomalies can be missed unless a careful search with macro and microscopic examinations and preparation.

Purpose of the research. To find out the efficiency of an improved method in diagnosis of coronary artery anomalies in autopsy material.

Materials and research methods. The improved method of diagnosis of coronary artery anomalies in autopsy material was taken to get the quality image of angioarchitectonics of coronary arteries by correcting the components of pouring mass which does not damage the vascular wall, to use the angiography, to improve the histological tissue techniques for histopathological study of coronary arteries, to establish the diagnosis. The autopsies were performed by the improved method at Lviv Regional Pathology Bureau. The pouring mass contained “Triombrastum” (manufacturer Farmak JSC, Ukraine), methylene blue and gelatine and was injected into the coronary arteries. Thereafter the an­giographic studies of coronary arteries were performed. The histological specimens of vascular wall were examined by the light microscopy.

Results of the investigation and their discussion. The improved method of diagnosis of the coronary artery anomalies in autopsy material was carried out in the following stages. In the first stage the heart was removed during the autopsy. The coronary arteries were injected by the pouring mass. In the second stage the heart was carried to a standard dental x-ray film in size of 305×405 mm. Angiographic studies were performed on the high-frequency dental X-ray unit “PLANMECA Intra” (manufacturer PLANMECA OY, Finland). In the third stage the sections of vascular wall were completed, followed by the painting of them according to standard histological and histochemical methods. The proposed method allows tincturing the sections of vessel wall with the help of standard histological and histochemical techniques after angiographic studies, to explore the postmortem changes of the coronary arteries, to detect the coronary arteries anomalies that is extremely important for the pathomorphological diagnosis and ex­plains the cause of myocardial ischemia.

Conclusions. The improved method of diagnosis of coronary artery anomalies in autopsy material is effective and can be used in the practice of pathology.

References

  1. Avtandilov G. Basics of pathology practices. Moskow: Medicine, 1994. 324 p. (Russian).
  2. Gorchakov V. Morphological studies of the vascular channel. Novosibirsk: Publishing House of the SB RAMS, 1997. 440 p. (Russian).
  3. Zerbino D, Kurylyak O, Boiko O. Anomalies of the coronary arteries. Heart and Vessels. 2014;2:81-90. (Ukrainian).
  4. Bolshakov O, Yuzhelevsky Yu, Petrishin V et al. The use of a low molecular weight rubber SKTN-MED for injections vessels. Archive Anat. 1983;85(7):88-92. (Russian).
  5. Seksyaev N, Bolotov I. Methods of making of corrosive materials on the example of coronary heart system. Bulletin of Medical Internet Conferences (ISSN 2224-6150). 2014;4(11):1282-1284. (Russian).
  6. Genç B, Solak A, Doksöz O, Tavli V. A patient with ischemic symptoms presents with left coronary artery-to-right ventricle fistula and agenesis of the right coronary artery. Turk Kardiyol Dern Ars. 2013;41(4):343-346.
  7. Turkmen S, Cagliyan CE, Poyraz F, Sercelik A, Boduroglu Y, Akilli RE et al. Coronary arterial anomalies in a large group of patients undergoing coronary angiography in southeast Turkey. Folia Morphol. 2013;72(2):123-127. https://doi.org/10.5603/FM.2013.0020
  8. Dubey L. Percutaneous coronary intervention of an obstructive left anterior descending artery with anomalous origin of right coronary artery. ARYA Atheroscler. 2013;9(2):164-166.
  9. Laux D, Bessières B, Houyel L, Bonnière M, Magny JF, Bajolle F et al. Early neonatal death and congenital left coronary abnormalities: Ostial atresia, stenosis and anomalous aortic origin. Arch Cardiovasc Dis. 2013;106(4);202-208. https://doi.org/10.1016/j.acvd.2013.01.002