Year: 2025
Type: article
Abstract: Purpose of the study. To summarize modern scientific information on the variant anatomy of the coronary arteries of the human heart, to analyze the main types and classifications of morphological variants of their branching and course, to identify the morphofunctional clinical significance of these variations for the diagnosis, surgical and endovascular treatment of human cardiovascular diseases.Material and methods of the study. The material for the review article consisted of scientific studies published between 2005-2025, these studies included both modern scientific studies of the morphological spectrum and classical, basic scientific works related to the anatomy of the coronary arteries of the heart.The search for scientific sources was conducted using databases as Google Scholar and PubMed. To more accurately identify the necessary articles and textbooks, the following keywords were used: heart, coronary arteries, coronary vessels, heart arteries, heart vessels, and morphology. A systematic analysis of literary sources was conducted with the unification and comparison of scientific data.Research results. The anatomy of the coronary arteries is characterized by significant interindividual variability, which is of great importance for diagnostic and interventional cardiology. This review summarizes current data on morphological variants of the right coronary artery, their angiographic features, embryonic origin and clinical significance. Special attention is paid to the description of benign anatomical variants, such as high origin, shepherd's hook configuration, variations in the origin and course of the right coronary artery and its branches. Most of them are of no clinical significance and are detected incidentally during coronary angiography performed for other reasons. However, some variants may create technical difficulties during catheterization or interventional procedures due to atypical course or sharp angles of the vessel origin. In rare cases, variants such as the descending septal branch arising from the right coronary artery may have a functional significance, providing collateral blood supply in the case of proximal occlusion of the anterior interventricular branch or serving as a target for alcohol septal ablation in hypertrophic obstructive cardiomyopathy. Understanding such anatomical nuances is key to the correct interpretation of coronary imaging results and the safe conduct of interventional procedures. Further studies combining morphometric, imaging, and embryological approaches are promising for improving the classification of right coronary artery variants and optimizing preoperative planning in patients with coronary anomalies.Conclusions. The literature review shows that the variant anatomy of the coronary arteries results from complex embryonic processes in the formation of the aortic root and coronary bed. Most anatomical variants described in scientific sources have no clinical significance and are considered individual features of the cardiovascular system. At the same time, knowledge of these variants is of great practical importance for clinicians, cardiac surgeons, and radiologists, as it helps avoid diagnostic errors and technical complications during coronary angiography, angioplasty, or surgical interventions on the heart. Thus, the systematization of data on the morphological and topographic features of the coronary vessels contributes to a deeper understanding of the individual anatomy of the heart and improves the quality of diagnosis and treatment of cardiovascular diseases.
Source: Bukovinian Medical Herald
Institution: Bukovinian State Medical University
Language: English
Topic: Coronary Artery Anomalies
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7117118702