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A cadaveric study of arteriovenous trigone of heart: the triangle of Brocq and Mouchet

  • Swati Bansal (Department of Anatomy, Kalpana Chawla Government Medical College) ;
  • Rajiv Jain (Department of Medicine, Nemi Chand Medical College) ;
  • Virendra Budhiraja (Department of Anatomy, Kalpana Chawla Government Medical College) ;
  • Shveta Swami (Department of Anatomy, Kalpana Chawla Government Medical College) ;
  • Rimpi Gupta (Department of Anatomy, Kalpana Chawla Government Medical College)
  • Received : 2022.11.25
  • Accepted : 2023.02.08
  • Published : 2023.06.30

Abstract

Left coronary artery divides into anterior interventricular branch and circumflex branch. As both the arteries run in their corresponding grooves, an arteriovenous trigone is formed between conus arteriosus and left auricle called triangle of Brocq and Mouchet. The triangle base is formed by great cardiac vein. This study aims to describe the frequency of triangle and its type and relationship between various boundaries and content of triangle and to supplement the existing knowledge of clinicians. This observational and descriptive study was conducted on 40 formalin fixed cadaveric hearts in department of anatomy, Kalpana chawla government medical college. The triangle was found in 92.5% of specimen with most common type being closed (51.3%) which is followed by inferiorly open in 35.1%, superiorly open in 8.1% and completely open in 5.4% hearts. Most frequent content of triangle was median artery followed by diagonal branches of anterior interventricular and circumflex branches. The mean area of the triangle was 246.3 mm2. Relationship of vein with two arterial branches was either superficial or deep. The knowledge of different patterns of existence will be required for angiographic procedures. Further the triangle is a potential epicardial access route to left fibrous ring. Thus detailed knowledge of variations will help cardiologist to achieve better outcome in interventional procedures with minimal complications.

Keywords

Acknowledgement

We would like to express our sincere gratitude to all the staff of Anatomy Department for their valuable support and encouragement.

References

  1. Sousa-Rodrigues CF, Alcantara FS, Silva WNV, Alcantara FS, Olave E. Arterio-venous trigone of the heart (Brocq & Mouchet trigone). Int J Morphol 2004;22:291-6. 
  2. Ortale JR, Gabriel EA, Iost C, Marquez CQ. The anatomy of the coronary sinus and its tributaries. Surg Radiol Anat 2001;23:15-21. 
  3. Pejkovic B, Bogdanovic D. The great cardiac vein. Surg Radiol Anat 1992;14:23-8. 
  4. Kharbuja R, Basnet L, Dhungel S. Anatomical study of triangle of Brocq and Mouchet in human cadaveric heart. Nepal Med Coll J 2020;22:111-7. 
  5. Kulkarni V, Ramesh BR. Incidence of triangle of Brocq and Mouchet and median artery as its content in south Indian cadaveric hearts. Clin Res 2014;6:4-9. 
  6. Roy SS, Dubey A. Triangle of Brocq and Mouchet: an anatomical study in human cadaveric heart and its clinical significance. Int J Anat Res 2016;4:2266-8. 
  7. Andrade FM, Ribeiro DC, Babinski MA, Cisne R, Goes ML. Triangle of Brocq and Mouchet: anatomical study in Brazilian cadavers and clinical implications. J Morphol Sci 2010;27:127-9. 
  8. Bharathi D, Sathyamurthy B. An anatomical study of triangle of Brocq & Mouchet in human cadaveric heart & its clinical relevance. J Dent Med Sci 2013;8:12-5. 
  9. Suma HY, Shanthini S. Relationship of great cardiac vein in the triangle of Brocq and Mouchet- a corrosion cast study. Int J Anat Res 2019;7:6437-42. 
  10. Kavimani, Jebakani CF. Coronary sinus. World J Med Sci 2014;10:61-4. 
  11. Kalpana R. A study on principal branches of coronary arteries in humans. J Anat Soc India 2003;52:137-40. 
  12. Gerber TC, Sheedy PF, Bell MR, Hayes DL, Rumberger JA, Behrenbeck T, Holmes DR Jr, Schwartz RS. Evaluation of the coronary venous system using electron beam computed tomography. Int J Cardiovasc Imaging 2001;17:65-75. 
  13. von Ludinghausen M. Clinical anatomy of cardiac veins, Vv. cardiacae. Surg Radiol Anat 1987;9:159-68. 
  14. James TN. Anatomy of the coronary arteries in health and disease. Circulation 1965;32:1020-33. 
  15. Nikolic V, Blagojevic Z, Stijak L, Malis M, Parapid GT, Stankovic G, Spasojevic G, Filipovic B. The third branch of the main trunk of the left coronary artery in Cercopithecus aethiops sabaeus. Is the nonhuman primate model appropriate? Anat Rec (Hoboken) 2011;294:1506-10.