Leaman et al developed a Coronary Score for a patient with coronary atherosclerosis. The authors are from Erasmus University in Rotterdam and Milton S. Hershey Medical Center.
Patient selection: coronary artery disease, before and after coronary artery bypass grafts (CABG)
Parameters:
(1) occlusion(s) seen on coronary angiography with distribution recorded according to the American Heart Association segments.
(2) left or right coronary artery dominance
Steps:
(1) Determine coronary artery dominance.
(2) Identify segments with significant occlusion (minimum 70% in Leaman et al. Brower et al use 50% with range 50-89% as lowest range).
(3) Determine score for that segment based degree of occlusion (1 score per segment).
(4) Summate the scores for all 15 segments.
Right Coronary Artery Dominance
|
Segment |
Name |
70-89% |
90-99% |
100% |
|---|---|---|---|---|
|
1 |
Right proximal |
1 |
3 |
5 |
|
2 |
Right second (to acute marginal branch) |
1 |
3 |
5 |
|
3 |
Right third (to right posterior descending) |
1 |
3 |
5 |
|
4 |
Right fourth (right posterior descending |
1 |
3 |
5 |
|
5 |
Left main |
5 |
15 |
25 |
|
6 |
LAD proximal |
3.5 |
10.5 |
17.5 |
|
7 |
LAD second |
2.5 |
7.5 |
12.5 |
|
8 |
LAD third |
1 |
3 |
5 |
|
9 |
Left diagnonal first |
1 |
3 |
5 |
|
10 |
Left diagonal second |
0.5 |
1.5 |
2.5 |
|
11 |
Left circumflex |
1.5 |
4.5 |
7.5 |
|
12 |
Left obtuse marginal |
1 |
3 |
5 |
|
13 |
Left atrial circumflex |
0.5 |
1.5 |
2.5 |
|
14 |
Left posterolateral |
0.5 |
1.5 |
2.5 |
|
15 |
Left posterior descending |
0 |
0 |
0 |
Left Coronary Artery Dominance
|
Segment |
Name |
70-89% |
90-99% |
100% |
|---|---|---|---|---|
|
1 |
Right proximal |
0 |
0 |
0 |
|
2 |
Right second (to acute marginal branch) |
0 |
0 |
0 |
|
3 |
Right third (to right posterior descending) |
0 |
0 |
0 |
|
4 |
Right fourth (right posterior descending |
0 |
0 |
0 |
|
5 |
Left main |
6 |
18 |
30 |
|
6 |
LAD proximal |
3.5 |
10.5 |
17.5 |
|
7 |
LAD second |
2.5 |
7.5 |
12.5 |
|
8 |
LAD third |
1 |
3 |
5 |
|
9 |
Left diagnonal first |
1 |
3 |
5 |
|
10 |
Left diagonal second |
0.5 |
1.5 |
2.5 |
|
11 |
Left circumflex |
2.5 |
7.5 |
12.5 |
|
12 |
Left obtuse marginal |
1 |
3 |
5 |
|
13 |
Left atrial circumflex |
1.5 |
4.5 |
7.5 |
|
14 |
Left posterolateral |
1 |
3 |
5 |
|
15 |
Left posterior descending |
1 |
3 |
5 |
Specialty: Cardiology
ICD-10: ,
