Dual or split right coronary artery also known as duplication of the right coronary artery is a congenital coronary artery anomaly of intrinsic coronary anatomy in which the right coronary artery is divided into two branches early.
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Epidemiology
This is very common if not the most common coronary artery anomaly and frequency has been estimated above 1% 1-4.
Clinical presentation
A split right coronary artery is considered benign and not associated with any symptoms and can be incidentally found on imaging studies.
Radiographic features
Split right coronary artery can be found on coronary CTA, coronary MRA or invasive coronary angiography (ICA). The right coronary artery bifurcates into an anterior and posterior branch. The anterior branch courses along the right ventricular free wall to the distal posterior interventricular groove and gives off a distal posterior descending branch, while the posterior branch stays in the atrioventricular groove and gives origin to a second proximal posterior descending branch in the peri-crux cordis area, which passes through the proximal portion of the interventricular groove 1-4.
Radiology report
The radiological report should include a description of the following features:
- right coronary artery origin, course and branch anatomy
- other associated coronary artery anomalies (e.g. hypoplastic circumflex artery)
- coronary artery disease and stenoses