Adriana C Gittenberger-de Groot1, Wilke M C Koenraadt2, Margot M Bartelings3, Regina Bökenkamp4, Marco C DeRuiter3, Mark G Hazekamp5, Ad J J C Bogers6, Jan M Quaegebeur7, Martin J Schalij2, Hubert W Vliegen2, Robert E Poelmann8, Monique R M Jongbloed9. 1. Cardiology, Leiden University Medical Center, Leiden, The Netherlands. Electronic address: acgitten@lumc.nl. 2. Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 3. Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands. 4. Pediatric Cardiology, Leiden University Medical Center, Leiden, The Netherlands. 5. Cardiothoracic Surgery, Leiden University Medical Center, Leiden, The Netherlands. 6. Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, The Netherlands. 7. Pediatric Cardiac Surgery, Presbyterian Morgan Stanley Children's Hospital, New York, NY. 8. Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Department of Animal Sciences and Health, Leiden University, Leiden, The Netherlands. 9. Cardiology, Leiden University Medical Center, Leiden, The Netherlands; Anatomy and Embryology, Leiden University Medical Center, Leiden, The Netherlands.
Abstract
OBJECTIVES: Variations in coronary anatomy are common and may relate to the position of the coronary ostium relative to the aortic sinus, the angle of coronary take-off, or the course of the coronary arterial branches. Several classification systems have been proposed. However, they all lack a simple rationale that is applicable irrespective of the relative position of the great arteries, as well as in bicuspid aortic valves. We present a modification of a relatively simple system introduced in the early 1980s, designated the "Leiden Convention." METHODS: The first step of the Leiden Convention is that the clinician takes position in the nonfacing sinus of the aorta looking toward the pulmonary orifice. The right-hand facing sinus is sinus 1, and the left-hand facing sinus is sinus 2. The coronary branches arising from sinus 1 are annotated proceeding in a counterclockwise fashion toward sinus 2. "Usual" (normal) coronary anatomy would be 1R-2LCx. Given their clinical relevance, single sinus coronary arteries are discussed separately. RESULTS: This system was originally designed and highly applicable in hearts with an altered great artery relationship, such as in the variable and complicated patterns seen in transposition of the great arteries and double outlet right ventricle. The modified system also can be used in cases with normally related great arteries, cases with single sinus coronary arteries, and cases with bicuspid aortic valves. CONCLUSIONS: The modified Leiden Convention is not a strict classification but a simple coronary coding system that is broadly applicable.
OBJECTIVES: Variations in coronary anatomy are common and may relate to the position of the coronary ostium relative to the aortic sinus, the angle of coronary take-off, or the course of the coronary arterial branches. Several classification systems have been proposed. However, they all lack a simple rationale that is applicable irrespective of the relative position of the great arteries, as well as in bicuspid aortic valves. We present a modification of a relatively simple system introduced in the early 1980s, designated the "Leiden Convention." METHODS: The first step of the Leiden Convention is that the clinician takes position in the nonfacing sinus of the aorta looking toward the pulmonary orifice. The right-hand facing sinus is sinus 1, and the left-hand facing sinus is sinus 2. The coronary branches arising from sinus 1 are annotated proceeding in a counterclockwise fashion toward sinus 2. "Usual" (normal) coronary anatomy would be 1R-2LCx. Given their clinical relevance, single sinus coronary arteries are discussed separately. RESULTS: This system was originally designed and highly applicable in hearts with an altered great artery relationship, such as in the variable and complicated patterns seen in transposition of the great arteries and double outlet right ventricle. The modified system also can be used in cases with normally related great arteries, cases with single sinus coronary arteries, and cases with bicuspid aortic valves. CONCLUSIONS: The modified Leiden Convention is not a strict classification but a simple coronary coding system that is broadly applicable.
Authors: Claire J Koppel; Diederick B H Verheijen; Philippine Kiès; Anastasia D Egorova; Hildo J Lamb; Michiel Voskuil; J Wouter Jukema; Dave R Koolbergen; Mark G Hazekamp; Martin J Schalij; Monique R M Jongbloed; Hubert W Vliegen Journal: Eur Heart J Open Date: 2022-05-02
Authors: Mehmet Dedemoğlu; Gültekin Coşkun; Fatih Özdemir; Okan Yurdakök; Oktay Korun; Murat Çiçek; Mehmet Biçer; Filiz İzgi Coşkun; Numan Ali Aydemir; Ahmet Şaşmazel Journal: Braz J Cardiovasc Surg Date: 2020-06-01
Authors: Claire J Koppel; Hubert W Vliegen; Regina Bökenkamp; A Derk Jan Ten Harkel; Philippine Kiès; Anastasia D Egorova; J Wouter Jukema; Mark G Hazekamp; Martin J Schalij; Adriana C Gittenberger-de Groot; Monique R M Jongbloed Journal: Eur Heart J Cardiovasc Imaging Date: 2022-02-22 Impact factor: 6.875