Right coronary artery anatomical variants: where and how?
BACKGROUND
Ectopic origin of the right coronary artery (RCA) occurs in approximately 1.0% of studied populations. We investigated the prevalence and location of ectopic RCAs among patients undergoing coronary angiography (CA) and assessed its effects on resource utilization.


METHODS
Cases of ectopic RCAs were prospectively collected over 21 months among patients undergoing cardiac catheterization at a University Hospital. "Ectopic RCA" was defined as a RCA originating outside the posterior two-thirds of the right coronary sinus.


RESULTS
The study population included 2,120 patients, of which 23 (1.1%) had ectopic RCAs. Of these, 15 (65%) originated from the anterior third of the right sinus, while 8 (35%) originated from the anterior half of the left sinus. Mean procedure and fluoroscopy times were 60 +/- 33 and 15 +/- 12 minutes (min) for the former, and 78 +/- 35 and 31 +/- 20 min for the latter, while mean contrast volume for CA was 112 +/- 62 ml and 192 +/- 85 ml, respectively. 26% required a second CA or a second intervention to image the RCA.


CONCLUSIONS
Ectopic RCAs pose a clinical problem, consuming time and resources. The search for an ectopic RCA should have < 90 degree boundaries limited to the anterior third of the right sinus and anterior half of the left sinus.
Solanki
Pallavi
P
Cardiac Catheterization Laboratories and Invasive Cardiology, University Hospital and University of Medicine and Dentistry of New Jersey, 185 South Orange Avenue, Newark, NJ 07101-1709, USA.
Gerula
Christine
C
Randhawa
Preet
P
Benz
Michael
M
Maher
James
J
Haider
Bunyad
B
Klapholz
Marc
M
Palmaro
Jack
J
Alfano
Diane
D
Kaluski
Edo
E
D000465:Algorithms; D002828:Choristoma / Q000000981:diagnostic imaging / Q000453:epidemiology; D017023:Coronary Angiography; D054326:Coronary Sinus / Q000002:abnormalities* / Q000000981:diagnostic imaging; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging / Q000453:epidemiology; D003331:Coronary Vessels / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal; D006801:Humans; D008279:Magnetic Resonance Imaging; D015995:Prevalence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed