The cristal (right superior septal) coronary artery and its relationship to anomalous left coronary origin

Area of Science:

• Cardiovascular Anatomy
• Interventional Cardiology

Background:

• The cristal artery is an infrequent coronary artery variant, identified in approximately 3% of coronary angiograms.
• It arises from the proximal right coronary artery (RCA) and traverses the crista superventricularis muscle.
• This artery supplies a portion of the superior interventricular septum and may participate in collateral circulation.

Purpose of the Study:

• To describe the anatomical course and significance of the cristal artery.
• To elucidate its role in differentiating anomalous left coronary artery (LCA) origins.
• To assess its potential association with sudden cardiac death risk.

Main Methods:

• Retrospective analysis of coronary angiograms.
• Anatomical description based on imaging findings.
• Correlation with clinical presentation and outcomes.

Main Results:

• The cristal artery arises from the proximal RCA, supplying the superior interventricular septum.
• Its pathway can mimic or coexist with anomalous LCA originating from the right sinus.
• Distinguishing its pathway from higher routes between great vessels is crucial for risk stratification.

Conclusions:

• The cristal artery is a distinct anatomical entity with implications for interpreting coronary angiograms.
• Identifying its course aids in diagnosing anomalous LCA originating from the right sinus.
• Understanding its pathway may refine risk assessment for sudden cardiac death.