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An Anomalous Configuration of Coronary Artery: A Cadaveric Study

DOI: 10.1155/2013/397063

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Abstract:

Anatomical variations in relation to coronary artery and its branches will help cardiac surgeons for refining imaging techniques and coronary artery bypass grafting. A heart was detected with multiple anomalies of coronary arteries in a cadaver. The anomalies of coronary arteries in terms of origin, number of ostia, courses, and presence of myocardial bridges were described, and related clinical implications were highlighted in the present study. The knowledge of variant anatomy may be of paramount importance to anatomists for variant anatomy and to cardiac surgeon for proper diagnosis and treatment of cardiac ailments including radiologists to refine image interpretation. 1. Introduction Rate of coronary-artery-related diseases is increasing by leaps and bounds in modern times. The anatomy of coronary artery has recently been reemphasized in association with the use of coronary arteriography. The advances made in coronary arterial bypass surgeries and modern methods of myocardial revascularization make sound and complete knowledge of the normal and variant anatomy of coronary artery [1] indispensable and imperative. Thus the variant cardiac anatomy is of paramount importance for proper understanding and management of cardiac diseases. The heart is supplied by two coronary arteries, that is, right coronary artery (RCA) and left coronary artery (LCA). RCA originates from anterior aortic sinus at the root of the ascending aorta and LCA from left posterior aortic sinus at the root of the ascending aorta. RCA after arising courses between pulmonary trunk and right auricle then travels in right coronary sulcus, then winds round the inferior border of heart, then runs over the inferior surface, and ends by anastomosing with circumflex branch of LCA. LCA after coursing between pulmonary trunk and left auricle divides into anterior interventricular artery and circumflex artery. In the present case RCA and LCA have aberrant courses along with separate ostium for ACA and anomalously located ostium for RCA. The trifurcated LCA after its origin is also covered by myocardial bridge. The clinical significance of this new configuration of coronary arteries with new variant of myocardial bridge makes this study of paramount importance in management of heart diseases for cardiac surgeons and variant anatomy for anatomists. Therefore the study has been carried out. 2. Case Presentation During routine dissection of cadaver of 50-year-old female, the heart was detected to have unique combination of variant configurations of RCA, ACA, and LCA in relation to origin, course,

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