title: Terminal branching pattern of the right coronary artery in left-dominant hearts: a cadaveric study.
abstract: BACKGROUND
  Left coronary dominance has been reported to be associated with increased mortality and severity in case of myocardial ischemia involving left coronary artery. The present cadaveric study was proposed to objectively study and document the termination and branching pattern of the right coronary artery in left-coronary-dominant hearts in relation to the blood supply to the posterior surface of the right ventricle.
  
  
  METHODS
  Seventy-five cadaveric hearts were studied. The coronary vessels were injected with colored cellulose acetate butyrate and dissected. The coronary dominance was determined. In left-dominant hearts, branches and termination of the right coronary artery were studied.
  
  
  RESULTS
  Left coronary dominance was found in 13% of the specimens. The number of ventricular branches was found to be present as 0, 1, 2, and 4 in two, four, two, and two of the cases, respectively. The average length of the ventricular branch was 12.7 mm with a range of 5-35 mm. The atrial branch was found in 50% of hearts, varying from 2 to 3 mm in length. In three hearts, the acute marginal artery did not give any posterior ventricular branch, while two, three, and five posterior ventricular branches were seen in four, two, and one heart(s), respectively. The length of the posterior ventricular arteries was between 5 and 15 mm.
  
  
  CONCLUSIONS
  The RCA is an inconstant and unreliable source of posterior right ventricular perfusion in a significant percentage of population with left-coronary-dominant hearts. This might be the reason for the increased morbidity and mortality seen in the event of left coronary ischemia.
authors.affiliation: Department of Anatomy, Postgraduate Institute of Medical Education & Research, sector-12, Chandigarh-160012, India. tulikag11@yahoo.com
authors.forename: Tulika
authors.initials: T
authors.lastname: Gupta
authors.forename: Abhimanyu
authors.initials: A
authors.lastname: Saini
authors.forename: Daisy
authors.initials: D
authors.lastname: Sahni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000033:anatomy & histology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult