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Intracavitary course of coronary arteries: a systematic review of case reports and case series

Hossameldin Hussein1,2, Mohammed Thabet1,3, Ahmed Magdi Youssef4,5

  • 1Department of Cardiology, Kasr Al-Ainy Medical School, Cairo University, Cairo, Egypt.

Indian Journal of Thoracic and Cardiovascular Surgery
|October 27, 2025
PubMed

Insights

Intracavitary (IC) coronary course, where arteries run within heart chambers, is under-recognized. This anatomical variant poses risks during cardiac interventions, necessitating careful management strategies.

Area of Science:

  • Cardiology
  • Anatomical Variants
  • Cardiac Surgery

Background:

  • Intracavitary (IC) coronary course is an anatomical variant where a coronary artery segment traverses within a cardiac chamber.
  • This condition is under-recognized by clinicians despite increasing reports.
  • Diagnosis is often incidental, but IC coronary course poses risks during cardiac interventions.

Purpose of the Study:

  • To review diagnostic modalities for IC coronary course.
  • To outline clinical hazards and necessary precautions during interventions.
  • To propose a management algorithm for IC left anterior descending (LAD) artery bypass grafting.

Main Methods:

  • Systematic literature review of case reports and series.
  • Inclusion of 200 patients diagnosed via CT, intraoperatively, or autopsy.
  • Analysis of diagnostic methods, intervention risks, and management strategies.

Main Results:

  • IC coronary course is diagnosed through various methods including CT and autopsy.
  • Percutaneous procedures and surgical dissection carry risks like myocardial ischemia and ventricular injury.
  • Graft anastomosis for IC LAD can be technically challenging.

Conclusions:

  • Accurate diagnosis and awareness of IC coronary course are crucial for patient safety.
  • Precautions are essential during cardiac interventions involving patients with this variant.
  • A structured approach and proposed algorithm can aid surgical management of IC LAD.

Keywords:
Intra-atrial right coronary arteryIntracavitary coronary courseIntracavitary left anterior descending arteryMyocardial bridge

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