Anomalous double right coronary arteries: characteristic multidetector-row computed tomography findings

To evaluate the characteristic multidetector-row computed tomography (MDCT) findings of anomalous double right coronary arteries (RCAs), an extremely rare variant.

During a 3-year period, 2569 patients with chest pain underwent MDCT coronary angiography. Five patients (0.2%) with anomalous double RCAs were found (mean age, 66 years; range, 43-81 years; 3 women). The location and number of orifice, anatomical distribution of the RCA and its branches, and presence of atherosclerosis were analyzed.

All the 5 cases of double RCAs originated from the right sinus of Valsalva and could be classified into 3 types according to the characteristics. One patient (type 1) had a double RCA arising from 2 separated orifices in the right sinus of Valsalva; another patient (type 2) had 2 separate RCAs originating from a common orifice in the sinus of Valsalva; the other 3 patients with double RCAs (type 3) had a common main RCA in the sinus of Valsalva with a proximal bifurcation, like the usual left coronary arterial system.

Our data showed that although a double RCA is a rare anomaly, it is easily detected using MDCT and can be classified into 3 types.