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A 52-year-old man underwent coronary computed tomography (CT) angiography for evaluation
of suspected atherosclerotic coronary artery disease (CAD). CT angiography revealed
a dual right coronary artery (RCA) with a single proximal trunk splitting into two
branches in the region of mid-RCA, immediately after origin of an early branching
acute marginal artery (AM). The two similar-sized branches were seen running closely
together in the right atrioventricular (AV) groove, for the rest of the course of
RCA (Figure 1A–C). The posterior branch had an intra-atrial course for a short segment before re-entering
the AV groove (Figure 1D). Both branches reached the crux of heart where the anterior branch and posterior
branch terminated as two distinct posterior descending arteries (arrowheads in Figure 1C). No obstructive CAD was noted.
Figure 1A–C: Volume rendered images show a single proximal trunk of right coronary artery
dividing into two branches after origin of acute marginal artery (AM). Both branches
reach the crux of heart and give off distinct posterior descending arteries (arrowheads).
D: Axial image demonstrates the intra-atrial course of the posterior branch. Abbreviations:
RA, right atrium; RV, right ventricle.
