Anomalous Anatomy

Coronary artery anomalies can vary from the number of vessels, origin, course, termination, and abnormalities in structure. Anomalies of the left coronary artery or right coronary artery can be a benign incidental finding or it can be a malignant finding causing clinical symptoms, including sudden death. Clinically, coronary artery anomalies can be divided into benign and malignant categories. Transeptal, prepulmonic, and retroaortic arterial tracts are categorized as benign and are clinically insignificant. An interarterial tract by a coronary artery however, is clinically significant and a malignant anomaly.

Malignant
Interarterial Course
An arterial course between the aorta and pulmonary artery at the level of pulmonary valve or right ventricular outflow tract.

Benign
Transeptal Course
The artery transverses the upper interventricular septum.

Prepulmonic Course
The artery tracts anterior to the pulmonary artery or right ventricular outflow tract.

Retroaortic Course
The artery tracts between the aortic root and left atrium, traveling posterior to the aorta.