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Anomalous Right Coronary Artery Course

Imaging findings

Coronary CTA in a patient post-repair of tetralogy of Fallot demonstrates two ascending aortic pseudoaneurysms at the sites of prior surgical cannulation. In addition, the right coronary artery (RCA) displays a congenital anomalous course, running directly through the cavity of the right atrium.

Key takeaways

An anomalous intra-cavitary course of a coronary artery (such as the RCA running through the right atrium) is a rare congenital anomaly that is typically asymptomatic. However, it represents a critical diagnostic finding in patients undergoing cardiac surgery or electrophysiological intervention, as catheters or surgical sutures in the right atrium can easily damage the anomalous vessel.

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