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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: yfchen@cc.kmu.edu.tw
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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 

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