Case report: Intra-atrial course of right coronary artery: Evaluation by dual-source CT

Abstract

We report a case of an anomalous course of the right coronary artery (RCA) through the right atrium, which was evaluated using dual-source CT angiography. There have been a few cases described previously in literature, but most of them were found either during surgery or at autopsy. Although this variant is clinically benign, it has significant consequences during interventional procedures or bypass surgery.

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“…The frequency of anomalous course of the right coronary artery through the right atrium in population is approximately 0.09–0.1% [ 1 , 3 ]. Andrade et al emphasize its asymptomatic character and this is the reason why it is incidental finding [ 2 ].…”

“…Anomalous course of the coronary artery may cause the risk of its injury during right heart catheterization, pacemaker implantation and ablation preceded by the electrophysiology testing [ 1 – 3 ]. An intracavitary right coronary artery could be disrupted, especially during ablation of typical atrial flutter which is performed along the cavotricuspid isthmus [ 1 , 2 ].…”

“…Complications caused by the injury of the arterial wall may result in myocardial ischemia or left-to-right shunt [ 2 , 3 ].…”

“…Identification of the intra-atrial course of the right coronary artery in conventional coronary angiography may be difficult [ 3 ]. Some authors emphasize that difficulties in vessel localization can occur during coronary artery bypass surgery.…”

Intracavitary course of right coronary artery

“…This is in context to a case report published in the Feb 2011 issue of the Indian Journal of Radiology and Imaging titled, “Case Report: Intra-atrial course of right coronary artery: Evaluation by dual-source CT” by Johann Christopher and Chary Duraikannu. [ 1 ]…”