Intramyocardial and intra-atrial courses in the right coronary artery: prevalence and characteristics

Area of Science:

• Cardiovascular Imaging
• Anatomical Variations
• Radiology

Background:

• Myocardial bridging (MB) and intra-atrial course anomaly (IARCA) are rare variations in the right coronary artery (RCA) anatomy.
• Accurate identification of these anomalies is essential for patient safety during cardiac procedures.

Purpose of the Study:

• To determine the prevalence and radiological characteristics of MB and IARCA in the adult population.
• To assess associated vascular anomalies and atherosclerosis in patients with RCA course variations.

Main Methods:

• Retrospective analysis of coronary CT angiography (CTA) images from adult patients.
• Inclusion criteria: presence of RCA MB or IARCA.
• Evaluation of patient demographics, co-existing anomalies, and coronary artery atherosclerosis (Agatston score, stenosis).

Main Results:

• Prevalence of RCA MB was 2.06%; prevalence of IARCA was 0.44%.
• Both anomalies were found concurrently in one patient.
• Average MB segment length was 21.9 mm; average IARCA segment length was 37.9 mm.
• No atherosclerotic disease was observed in the anomalous RCA segments.

Conclusions:

• Prevalence of RCA MB and IARCA established in the studied adult population.
• Importance of recognizing these rare RCA anomalies prior to interventions like ablation or surgery to avoid potentially fatal complications.