Hostname: page-component-745bb68f8f-hvd4g Total loading time: 0 Render date: 2025-01-10T20:37:00.298Z Has data issue: false hasContentIssue false
  • English
  • Français

Double right coronary artery and its clinical implications

Published online by Cambridge University Press:  05 March 2013

Tsu-Ming Chien ,
Chih-Wei Chen ,
Huai-Min Chen ,
Chee-Siong Lee ,
Ching-Cheng Lin  and
Ying-Fu Chen
Tsu-Ming Chien
Affiliation:
Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan
Chih-Wei Chen
Affiliation:
School of Medicine, Chung Shan Medical University, Taichung, Taiwan
Huai-Min Chen
Affiliation:
Division of Cardiovascular Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan
Chee-Siong Lee
Affiliation:
Division of Cardiology, Kaohsiung Medical University, Kaohsiung, Taiwan
Ching-Cheng Lin
Affiliation:
Division of Cardiology, Kaohsiung Medical University, Kaohsiung, Taiwan
Ying-Fu Chen*
Affiliation:
Division of Cardiovascular Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
*
Correspondence to: Dr Y.-F. Chen, MD, PhD, Division of Cardiovascular Surgery, Department of Surgery, Kaohsiung Medical University Hospital, 100, Shih-Chuan 1st Rd, Kaohsiung, Taiwan. Tel: 886-7-3121101 (ext 5801–3); Fax: 886-7-3127056; E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Congenital anomalies of the coronary arteries are present in 0.2–1.4% of the general population. These anomalies represent one of the most confusing issues in the field of cardiology and challenges for interventional cardiologists and cardiac surgeons if the anomalies are unrecognised. Double right coronary artery is one of the rarest coronary arteries. Previously, the probability of developing atherosclerotic changes in patients with a double right coronary artery was considered to be equal to that in those without it. In reality, however, a high prevalence of atherosclerotic coronary artery disease was found in patients with a double right coronary artery originating from a single ostium after our comprehensive literature search through the PubMed database. Owing to the fact that double right coronary artery is both a congenital and potentially atherosclerotic coronary artery disease at diagnosis, coronary intervention or cardiac operation is more complicated than previously believed. Individuals with a double right coronary artery may be unaware of its presence until an accidental finding during coronary angiography or cardiac operation and are at risk for unsuspected complications of atherosclerotic coronary artery disease or during cardiac operation. Therefore, it is important to obtain information on the anatomic variants of this congenital coronary anomaly in patients who are undergoing either coronary intervention, aortic root operation or myocardial revascularisation. To our knowledge, this is the first comprehensive article to discuss the anomalies and their clinical implications.

Keywords

Congenital anomalies of the coronary arteriesdouble right coronary arterysplit right coronary arterycoronary artery diseasepercutaneous coronary intervention
Type
Review Articles
Information
Cardiology in the Young , Volume 24 , Issue 1 , February 2014 , pp. 5 - 12
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Jacobs, ML, Mavroudis, C. Anomalies of the coronary arteries: nomenclature and classification. Cardiol Young 2010; 20 (3 Suppl): 15–19.CrossRefGoogle Scholar
2. Harikrishnan, S, Jacob, SP, Tharakan, J, et al. Congenital coronary anomalies of origin and distribution in adults: a coronary arteriographic study. Indian Heart J 2002; 54: 271–275.Google Scholar
3. Yamanaka, O, Hobbs, RE. Coronary artery anomalies in 126,595 patients undergoing coronary arteriography. Cathet Cardiovasc Diagn 1990; 21: 28–40.Google Scholar
4. Kunimasa, T, Sato, Y, Ichikawa, M, et al. MDCT detection of double right coronary artery arising from a single ostium in the right sinus of Valsalva: report of 2 cases. Int J Cardiol 2007; 115: 239–241.Google Scholar
5. Misuraca, L, Balbarini, A. Double right coronary artery or split right coronary artery: the same anomaly? J Cardiovasc Med (Hagerstown) 2010; 11: 398.Google Scholar
6. Topaloglu, S, Aras, D, Bicer, A, Ergun, K, Baser, K, Korkmaz, S. Double right coronary artery arising from the left main stem and right coronary sinus associated with ventricular septal defect in an adult: an extremely rare case. Heart Lung Circ 2007; 16: 318–321.Google Scholar
7. Sato, Y, Kunimasa, T, Matsumoto, N, Saito, S. Detection of double right coronary artery by multi-detector row computed tomography: is angiography still gold standard? Int J Cardiol 2008; 126: 134–135.Google Scholar
8. Chen, YF, Chien, TM, Chen, CW, Lin, CC, Lee, CS. Double right coronary artery or split right coronary artery? Int J Cardiol 2012; 154: 243–245.Google Scholar
9. Chien, TM, Lee, CS, Lin, CC, Chen, YF. The correct case numbers of double right coronary arteries. Int J Cardiol 2011; 153: 234–236.Google Scholar
10. Gupta, SK, Abraham, AK, Reddy, NK, Moorthy, SJ. Supernumerary right coronary artery. Clin Cardiol 1987; 10: 425–427.Google Scholar
11. Aydogdu, S, Ozdemir, M, Diker, E, Korkmaz, P, Sozutek, Y, Kutuk, E. Double right coronary artery. A rare coronary artery anomaly. Acta Cardiol 1997; 52: 359–361.Google Scholar
12. Harikrishnan, S, Bhat, A, Tharakan, JM. Double right coronary artery. Int J Cardiol 2001; 77: 315–316.Google Scholar
13. Altunkeser, BB, Ozdemir, K, Murat, SN. A unique double right coronary artery abnormality. Acta Cardiol 2001; 56: 259–260.Google Scholar
14. Timurkaynak, T, Ciftci, H, Cengel, A. Double right coronary artery with atherosclerosis: a rare coronary artery anomaly. J Invasive Cardiol 2002; 14: 337–339.Google Scholar
15. Garg, N, Goel, PK, Sinha, N. Double-right-coronary-artery with anomalous left main and septal arteries originating from the right coronary sinus. Indian Heart J 2002; 54: 428–431.Google Scholar
16. Lemburg, SP, Peters, SA, Scheeler, M, Nicolas, V, Heyer, CM. Detection of a double right coronary artery with 16-row multidetector computed tomography. Int J Cardiovasc Imaging 2007; 23: 293–297.Google Scholar
17. Karabay, KO, Catakoglu, AB, Demiroglu, ICC, Aytekin, V. Double right coronary artery originating from separate orifices – a case report and review of the literature. Int J Cardiol 2007; 118: e6–e7.Google Scholar
18. Capunay, C, Carrascosa, P, Deviggiano, A. MDCT detection of double right coronary artery arising from two separated ostia in the right sinus of Valsalva. Int J Cardiol 2010; 139: e33–e35.Google Scholar
19. Astan, R, Kacmaz, F, Maden, O, Turkvatan, A. Double right coronary artery from different ostia. Inter Med 2010; 49: 1249.CrossRefGoogle ScholarPubMed
20. Chen, YF, Chien, TM, Lee, CS. Coronary aneurysm with double right coronary artery and fistula. J Thorac Cardiovasc Surg 2011; 141: 585.Google Scholar
21. Egred, M, Shakespeare, CF, Pennell, D, Corr, L. Magnetic resonance angiography in the assessment of a first reported case of duplicate right coronary artery. Int J Cardiol 2005; 101: 329–331.Google Scholar
22. Karaosmanoglu, D, Karcaaltincaba, M, Akata, D. Duplicated right coronary artery: multidetector CT angiographic findings. British J Radiol 2008; 81: e215–e217.Google Scholar
23. Ciftci, H, Tacoy, G, Yazici, G. Duplication of the right coronary artery in a patient with hypertrophic cardiomyopathy and myocardial bridging. Cardiol Young 2009; 19: 627–629.Google Scholar
24. Huang, ZQ, Chen, SJ, Chen, J. Dual right coronary artery associated coronary artery fistula. Eur Heart J 2008; 29: 968.Google Scholar
25. Chen, HY. Aberrant origin of the conus branch: diagnosis of split right coronary artery with two separate ostia by conventional angiography. Exp Clin Cardiol 2010; 15: 9–10.Google Scholar
26. Barthe, JE, Benito, M, Sala, J, et al. Double right coronary artery. Am J Cardiol 1994; 73: 622.Google Scholar
27. Altun, A, Akdemir, O, Erdogan, O, Ozbay, G. An interesting diagnostic dilemma: double right coronary artery or high take off of a large right ventricular branch. Int J Cardiol 2002; 82: 99–102.Google Scholar
28. Nair, K, Krishnamoorthy, KM, Tharakan, JA. Double right coronary artery with anomalous origin of septal arteries from the right coronary sinus. Int J Cardiol 2005; 101: 309–310.Google Scholar
29. Sari, I, Kizilkan, N, Sucu, M, et al. Double right coronary artery: report of two cases and review of the literature. Int J Cardiol 2008; 130: e74–e77.Google Scholar
30. Resatoglu, AG, Elnur, EE, Yener, N, Elhassan, H, Yener, A. Double right coronary artery; fistula and atherosclerosis. Jpn J Thorac Cardiovasc Surg 2005; 53: 283–285.Google Scholar
31. Ozeren, A, Aydin, M, Bilge, M, Dursun, A, Onuk, T. Atherosclerotic double right coronary artery and ectasia of left coronary arteries in a patient with presented acute coronary syndrome and ventricular tachycardia. Int J Cardiol 2005; 102: 341–343.Google Scholar
32. Erbagci, H, Davutoglu, V, Turkmen, S, Kizilkan, N, Gumusburun, E. Double right coronary artery: review of literature. Int J Cardiovasc Imaging 2006; 22: 9–11.CrossRefGoogle ScholarPubMed
33. Sari, I, Uslu, N, Gorgulu, S, Nurkalem, Z, Eren, M. Inferior myocardial infarction and extensive atherosclerosis in a patient with double right coronary artery. Int J Cardiol 2006; 111: 321–323.Google Scholar
34. Gulel, O, Yazici, M, Durna, K, Demircan, S. A rare coronary anomaly: double right coronary artery. Clin Cardiol 2007; 30: 309.Google Scholar
35. Tatli, E, Buyuklu, M, Altun, A, Yilmaztepe, M. A patient with double right coronary artery and acute inferior myocardial infarction due to the critical lesion in one of them. Int J Cardiol 2007; 119: e30–e31.Google Scholar
36. Rohit, M, Bagga, S, Talwar, KK. Double right coronary artery with acute inferior wall myocardial infarction. J Invasive Cardiol 2008; 20: E37–E40.Google Scholar
37. Misuraca, L, Rutigliano, D, Pestrichella, V, Contegiacomo, G, Balbarini, A. A very rare congenital abnormality: double right coronary artery. A case report. J Cardiovasc Med 2009; 10: 643–645.Google Scholar
38. Sucu, M, Ozer, O, San, I, Davutoglu, V. Successful percutaneous coronary intervention for severe stenosis of a double right coronary artery. Kardiol Pol 2009; 67: 924–925.Google Scholar
39. Selcoki, Y, Yilmaz, OC, Er, O, Eryonucu, B. Double right coronary artery: a report of two cases. Clinics 2010; 65: 449–451.Google Scholar
40. Akcay, A, Koroglu, S, Kaya, H, Koleoglu, M, Acar, G. An unusual appearance of double right coronary artery. Cardiol Res Pract 2010; 2010: 123846.CrossRefGoogle ScholarPubMed
41. Ciftci, H, Bellur, G, Kavak, V, Tacoy, G. A rare coexistence: left coronary arteries arising from a double right coronary artery. Arch Turk Soc Cardiol 2011; 39: 177.Google Scholar
42. Acet, H, Ozyurtlu, F, Bilik, MZ, Ertas, F. A rare coronary anomaly: atypical double right coronary artery with an acute inferior myocardial infarction. Korean Circ J 2012; 42: 208–211.Google Scholar
43. Singh, AK, Pandey, AK. A case of double right coronary artery with bifurcation stenosis in association with complete heart block. J Cardiovasc Dis Res 2012 ; 3: 242–244.Google Scholar
44. Sawaya, FJ, Sawaya, JI, Angelini, P. Split right coronary artery: its definition and its territory. Tex Heart Inst J 2008; 35: 477–479.Google Scholar
45. Andreou, AY. Split right coronary artery (Letter to the Editor). J Cardiovasc Med 2010; 11: 399–400.Google Scholar
46. Okmen, AS, Okmen, E. Split right coronary artery: a report of two cases. Arch Turk Soc Cardiol 2010; 38: 38–40.Google Scholar
47. Soydinc, S, Sari, I, Davutoglu, V. The dilemma in diagnosing double right coronary artery: contribution of multidetector computed tomography. Int J Cardiol 2008; 126: 132–133.Google Scholar
48. Sato, Y, Kunimasa, T, Matsumoto, N, Saito, S. Detection of double right coronary artery by multi-detector row computed tomography: is angiography still gold standard? Int J Cardiol 2008; 126: 134–135.Google Scholar
49. McConnell, MV, Ganz, R, Selwyn, AP, Li, W, Edelman, RR, Manning, WJ. Identification of anomalous coronary arteries and their anatomic course by magnetic resonance coronary angiography. Circulation 1995; 92: 3158–3162.Google Scholar
50. Dai, G, Kaazempur-Mofrad, MR, Natarajan, S, et al. Distinct endothelial phenotypes evoked by arterial waveforms derived from atherosclerosis-susceptible and – resistant regions of human vasculature. Proc Natl Acad Sci USA 2001; 101: 14871–14876.Google Scholar
51. Cheng, C, Tempel, D, van Haperen, R, et al. Atherosclerotic lesion size and vulnerability are determined by patterns of fluid shear stress. Circulation 2006; 113: 2744–2753.CrossRefGoogle ScholarPubMed
52. Angelini, P. A rare coronary anomaly: double right coronary artery (Letter to the Editor). Clin Cardiol 2008; 31: 186.Google Scholar