title: The clinical anatomy of the conal artery.
abstract: Coronary arteries have been extensively described and recognized by gross anatomic studies. However, in the clinical setting, the recognition of the conal artery is essential during coronary angiography, as well as certain congenital heart conditions such as tetralogy of Fallot. In order to provide a complete anatomic and physiologic correlation of the actual incidence and distribution of the conal artery we examined 300 formalin fixed hearts with gross dissections and 300 coronary angiograms. The conal artery was identified in all hearts examined and five main patterns were recognized. In Type A (193, 32.1%), the conal artery arose as a branch of the right coronary artery (RCA); in Type B (96, 16%), the conal artery arose from the common coronary ostium with the RCA; in Type C (242, 40.3%), the conal artery took origin from the right aortic sinus as an independent artery; in Type D (48, 8%), multiple conal arteries were present and arose from the RCA as separate branches (32, 66.6%), from a common ostium with the RCA (8, 16.6%) or from the aortic sinus (8, 16.6%); in Type E (22, 3.6%), the conal artery arose as a branch of the right ventricular branch (17, 2.8%) or acute marginal artery (5, 0.8%). The relative prevalence of the five patterns as well as the morphology and the topography of the conal artery varied significantly with the degree of coronary luminal stenosis (as observed during angiography) and also with the degree of hypertrophied ventricular wall (as observed during gross dissections).
authors.affiliation: Department of Anatomical Sciences, St. George's University, Grenada, West Indies.|Department of Anatomy, Varmia and Mazuria Medical School, Olsztyn, Poland.
authors.forename: Marios
authors.initials: M
authors.lastname: Loukas
authors.affiliation: Department of Anatomical Sciences, St. George's University, Grenada, West Indies.|Department of Medicine, University of Nevada SOM, Las Vegas, Nevada.
authors.forename: Swetal
authors.initials: S
authors.lastname: Patel
authors.affiliation: Department of Anatomical Sciences, St. George's University, Grenada, West Indies.|Departments of Neurologic and Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota.
authors.forename: Alper
authors.initials: A
authors.lastname: Cesmebasi
authors.affiliation: Department of Cardiovascular Surgery, The University Hosptial of Bucharest, Romania.
authors.forename: Horia
authors.initials: H
authors.lastname: Muresian
authors.affiliation: Department of Anatomical Sciences, St. George's University, Grenada, West Indies.|Division of Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama.
authors.forename: R Shane
authors.initials: RS
authors.lastname: Tubbs
authors.affiliation: Department of Pediatrics-Cardiology, University of Florida, Gainesville, Florida.
authors.forename: Diane
authors.initials: D
authors.lastname: Spicer
authors.affiliation: Department of Cardiology, Bielany Hospital, Warsaw, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Dabrowski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D063405:Anatomic Variation; D003331:Coronary Vessels / Q000033:anatomy & histology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: conal artery; conus; coronary anastomosis; infundibular artery; left anterior descending artery; myocardial infarction; right coronary artery; right ventricular free wall; tetralogy of Fallot repair; third coronary artery