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Anatomic study of the morphology of the right and left coronary arteries.
Folia Morphologica (Warsz) 2017 May 30
Arising from the aorta, the right (RCA) and left (LCA) coronary arteries provide the arterial supply to both the atria and the ventricles of the heart. An extensive literature review revealed that most studies have either evaluated the morphology of the RCA or the LCA independently. This study aimed to document the relationship between the morphology of the RCA and LCA using coronary angiograms. In addition, variations such as split or double RCA and an absent LCA was documented. A review of 500 coronary angiograms was conducted and the RCA and LCA were classified according to their branching patterns and arterial dominance. The most prevalent branching pattern of the LCA was bifurcation [in 65.8% (³²⁹/₅₀₀)], while trifurcation and quadrifurcation occurred in 20.4% (¹⁰²/₅₀₀) and 1.6% (⁸/₅₀₀), respectively. The LCA was absent in 11.8% (⁵⁹/₅₀₀) of cases with the bifurcation and trifurcation of its branches in 10.8% (⁵⁴/₅₀₀) and 1.4% (⁷/₅₀₀), respectively. The splitting of the RCA occurred in 4.2% (²¹/₅₀₀) of the angiograms. A split RCA with concomitant absent LCA was documented in 1.2% (⁶/₅₀₀) of the angiograms. The RCA and LCA were dominant in 77.2% (³⁸⁶/₅₀₀) and 9.8% (⁴⁹/₅₀₀) of cases respectively, whereas co-dominance occurred in 13% (⁶⁵/₅₀₀) of the sample examined. In most cases where a split RCA was present, the RCA was found to be non-dominant. With the advent of coronary arteriography, a comprehensive understanding of coronary arterial anatomy and their anomalies has become essential.
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