Evaluation of the diagnostic values of coronary angiography to detect intramyocardial left anterior descending artery: an objective approach.

Abstract

Objective: The Left anterior descending artery is the most involved vessel in intramyocardial bridging of the coronary arteries. Revascularization of the left anterior descending artery is considered an essential component of coronary artery bypass grafting procedures. This study aims to evaluate the correlation between angiographic views of the coronary artery and intraoperative findings of intramyocardial left anterior descending artery. Methods: Between January 2015 and October 2022, 468 patients underwent coronary artery bypass grafting. Patients were divided into two groups based on the presence of an intramyocardial left anterior descending artery on coronary angiography group or intraoperatively. A total of 349 patients were included in the the study The correlation between the sign of depression of the left anterior descending artery on coronary angiography and intraoperative observations was investigated. Results: In the coronary angiography group 50 patients had signs of depression on coronary angiography, of which 35 had an intramyocardial left anterior descending artery intraoperatively. In the CABG group, 40 patients were found to have an intramyocardial left anterior descending artery intraoperatively and 5 had normal coronary angiography images. The prevalence of intramyocardial left anterior descending artery was 11.5%. The sensitivity of coronary angiography was measured as 87.5% [95% CI: 73.20% to 95.81%] and specificity was 95.15% [ 95% CI: 92.12% to 97.26%], positive predictive value was 70% [ 95% CI: 58.51% to 79.55%], and negative predictive value was 98.32% [ 95% CI: 96.27% to 99.25%]. Conclusion: The depression sign of the left anterior descending artery on coronary angiography correlates with intraoperative observations with high sensitivity and specificity