Origin of triple right coronary with separate ostium

Area of Science:

• Cardiology
• Anatomical Variations
• Congenital Heart Disease

Background:

• Coronary artery anomalies (CAAs) are relatively uncommon but can have significant clinical implications.
• This report focuses on a specific, rare CAA involving multiple right coronary arteries (RCAs) originating from the anterior aortic sinus.

Discussion:

• The described anomaly features three RCAs with separate ostia and a single left coronary artery (LCA) arising from the left posterior aortic sinus.
• One RCA followed a retro-aortic course, passing between the aorta and atria, and terminated as the circumflex artery.
• The LCA lacked a circumflex branch, with this territory supplied by an anomalous RCA.

Key Insights:

• Detailed anatomical description of a unique three-right-coronary-artery anomaly.
• Highlights the potential for complex branching patterns and unusual courses of coronary arteries.
• Emphasizes the importance of recognizing such variations in clinical settings.

Outlook:

• Further investigation into the embryological basis of such complex CAAs may be warranted.
• Increased awareness among clinicians can improve diagnostic accuracy and patient management.
• This case contributes to the literature on coronary artery anomalies, aiding in surgical planning and risk assessment.