Intra-atrial course of the right coronary artery

Last revised by Francis Deng on 31 Jan 2020

Intra-atrial course of the right coronary artery is an uncommon anatomic variation in the course of the right coronary artery, usually involving the mid and distal segments, where the vessel partially or completely courses through the right atrial chamber. It is the most common intracavitary (intracameral) coronary artery variant 3.

It is usually asymptomatic and clinically occult but is of radiological significance in any fluoroscopic procedure requiring a wire or catheter to be passed through the right atrium, in which it is prone to injury causing right coronal artery territory ischemia or infarction. It may also be injured during tricuspid valve surgery, coronary artery catheterization and bypass grafting.

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