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Abstract
Background/Introduction
The right coronary artery (RCA) arises from the right aortic sinus. In its course
in relation to the atrioventricular groove (AVG), it is submerged in the adipose tissue
of the epicardium. It continues towards the posterior interventricular groove often
crossing the crux of the heart.
Aims/Objectives
To trace the RCA and determine the variation in its course
Method
The heart of a well embalmed male cadaver is dissected to trace the RCA in the right
AVG. The branches are traced to determine the variation in the course of the RCA.
Results
During the exposure of RCA, the right AVG was found unoccupied. Further probing did
reveal the atrial branches bearing a proximal origin, but no ventricular branches
in the right AVG. On tracing the atrial branches to their origin, the RCA was visible.
The RCA had a normal origin from the right aortic sinus. Soon after, instead of being
submerged in the adipose tissue, it produced a unique pattern of looping with two
corners and the loop rose above the surface of the heart. The space underneath the
loop was filled with adipose tissue. The RCA then exited the AVG and went astray into
the myocardium of the right ventricle. Within the wall of right ventricle, the artery
initially pursued a superficial course giving rise to ventricular branches in the
direction of the left ventricle. Few of the ventricular branches produced elevations
on the surface of the right ventricle. For the further part, the RCA did not enter
the AVG and hence did not reach the crux. Due to its intra-myocardial course, the
right marginal artery was not seen on the surface of the heart. The coronary sinus
was the sole relation to the AVG.
Discussion/Conclusion
In this case, the RCA and its ventricular branches appear muzzled by the myocardium
of the right ventricle. Such a variation in the course of RCA accompanied by the unique
looping pattern is rare. It may pose a tough challenge to the radiologists and cardiologists
in performing various procedures such as coronary stenting involving the RCA
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Conference name:
World Society of Cardiothoracic Surgeons 25th Anniversary Congress, Edinburgh