The Clinical Anatomy of the Coronary Arteries–An Anatomical Study on 100 Human Heart Specimens by Horia Muresian

This is a superb 191-page treatise on the human coronary arteries, written by a clinician anatomist, pulling together everything a clinician (surgical or medical), or anatomist, would want to ever know about the coronary vessels. It starts with a compelling chapter on the use of terminology. For the anatomist, it is great to see the clinician advocating the use of anatomical terminology rather than the more usual clinical terminology, especially of the anterior interventricular artery instead of the left anterior descending artery. Throughout the text, the numerous variations of the coronary vessels are clearly explained. Positioning of the vessels indicates the areas of supply, justifying the use of anatomical terminology. Clear rationales are given for the names of various key branches, especially the ramus intermedius, a vessel that can give the left coronary artery the appearance of trifurcating rather than bifurcating. For each variation, there is normally a photograph of an exquisitely dissected heart. When reviewing the origin of these vessels, the author illustrates through diagrams the many variations that can occur when the great vessels do not lie in their normal position. For the non-embryologist, the second chapter on ‘‘Embryological highlights’’ is just that. It explains clearly that while the simple heart develops and starts functioning as a bilaminar structure (endocardium and myocardium), the coronary vessels develop as separate structures on the outside of the ‘‘naked’’ embryonic heart, ensheathing it to create the epicardium and so forming the definitive trilaminar arrangement of the heart wall. The author has drawn together the literature on the coronary vessels from many disciplines involved in cardiac research: physiology, gross anatomy, embryology, and the various clinical disciplines involved in treating cardiac problems. As such it is a great example of a modern Clinical Anatomy text illustrated to a high standard. The text is useful in the dissecting room to put in context some of the variations noted and pathologists will find this invaluable too. Physicians and surgeons in training will find it useful as they develop their personal three-dimensional imagery of the heart, joining up prior learning from their student days and better understanding the clinical anatomy of the heart seen through angiography and ultrasound. Notes of caution are there for the clinician throughout. When trying to interpret particular angiograms which do not appear to have the normal branching pattern, a useful question is ‘‘Is it pathological or a normal anatomical variant that I have not seen before?’’ Although much of the text will not be required for the anatomist, it will be a pleasure to look at and review the illustrations before heading into the practical lab on the coronary vessels.