Coronary arteries from a single coronary ostium in the right coronary sinus: a previously unreported anatomy

Abstract

The coronary circulation originating from a single coronary ostium is rare. All possible anatomical variations were the basis of a recent classification. This case report describes a previously unreported IID(1) pattern, comprising a solitary coronary ostium in the right coronary sinus with an anatomical course of the right coronary artery. The left circumflex coronary artery arises from the proximal right coronary artery coursing behind the aorta to the left. The left anterior descending coronary artery arises from the proximal right coronary artery coursing to the left side anterior to the right ventricle.

Figure 1

The right coronary artery (RCA) arises from the solitary coronary ostium (arrow) and runs in the atrioventricular groove. The left anterior descending (LAD) and left circumflex (C_X) arise from the right coronary artery, 1 cm from the ostium. The right circumflex runs to the left between the aorta (A) and atria (a). The left anterior descending runs across the anterior right ventricle to reach the anterior interventricular groove.

Figure 2

Diagramatic representation of the course of the coronary arteries from above, in the same orientation as fig 1. PT, pulmonary trunk; A, Aorta; MV, mitral valve; TV, tricuspid valve; LAD, left anterior descending artery; RCA, right coronary artery; C_X, circumflex artery.

Figure 3

Diagramatic representation of the course of the coronary arteries from the front. AA, aortic arch; RA, right atrium; LAD, left anterior descending artery; RCA, right coronary artery; C_X, circumflex artery.