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Variant Distribution of the Right Coronary Artery at the Crux of the Heart (Anatomical and Multislice CT Imaging Study)
Author(s) -
ElMaasarany Shirley Hilal,
AboulEnein Fatma Adel
Publication year - 2009
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.23.1_supplement.641.7
Subject(s) - medicine , right coronary artery , artery , ventricle , multislice computed tomography , coronary arteries , anatomy , multislice , interventricular septum , left coronary artery , myocardial bridge , computed tomography , radiology , cardiology , coronary angiography , myocardial infarction
Background In case of dominance of the right coronary artery RCA (80%‐90%), the later reaches the crux to give the posterior interventricular artery (posterior descending artery PDA) , the atrio‐ventricular nodal artery AVNA and continues to give postero‐lateral branches that supply the inferior surface of the left ventricle. Aim The aim of the present work was to study the course, relations and distribution of the right coronary artery at the crux of the heart and its variations. Material and methods Twenty embalmed human hearts showing no gross pathological lesions in the walls of the chambers were used. The crux of the heart was dissected to study the arteries in this region, their origin, relations and their destinations. Multi‐slice Computed Tomography MSCT of twenty healthy individual, with no obstructed lesions were studied retrospectively. Results At the crux the RCA forms a loop upwards which gives the PDA of a considerable size and smaller AVNA. Double and triple PDAs were seen in two specimens. AVNA, in the majority of specimens, took origin from the loop of the RCA. It coursed upwards and forwards in the inferior septal space ISS to reach the AVN. Variant origin of the AVNA was seen in three of the specimens, where it took origin from the PDA or from its first septal perforator. Double AVNA was encountered in 4 of the 20 specimens. In MSCT the AVNA was recognized by its vertical course off the distal RCA. Conclusions These variant anatomical findings should be considered during various interventional and surgical procedures encountering the crux of the heart.