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In an unselected series of 1050 human hearts the coronary arteries were uniformly injected at necropsy with a standardized radiopaque mass. Interarterial coronary anastomoses were clearly demonstrated by this method and were studied with respect to their incidence and pathogenesis. Anastomoses were significantly increased in hearts with coronary artery occlusion or marked narrowing in cor pulmonale, in cardiac hypertrophy and valvular lesions, and also in normal hearts from patients with anemia. Relative cardiac anoxia is present in all these conditions; it appears to be a common underlying stimulus for the development of interarterial coronary anastomoses.

Interarterial Coronary Anastomoses in the Human Heart, with Particular Reference to Anemia and Relative Cardiac Anoxia