Right coronary artery intra-cavitary course
Incidental finding on coronary CT.
ECG-gated coronary CT angiogram
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Right coronary artery is initially seen to run in the epicardial fat, but the mid-RCA (arrows) subsequently runs inside the right atrium (intra-cavitary) instead of within the epicardial fat.
Intra-cavitary course of the right coronary artery is increasingly recognized with improving CT technology. The significance of this course is that it may complicate bypass grafting, and the RCA can be accidentally damaged during pacemaker insertion, invasive electrophysiological procedures, or right heart catheterization.