Publication:

Anatomical variations in coronary artery origin, branching pattern, dominance and morphometry: a cadaveric study from Northeast India

Background The coronary arteries exhibited significant anatomical variability in its origin, branching pattern, and dominance. Accurate knowledge of these variations is essential for the interpretation of coronary angiography and the planning of percutaneous coronary intervention, coronary artery bypass grafting, and aortic root surgeries. Cadaveric studies provide detailed anatomical information that is invaluable for clinical practice.

Methods A descriptive cross-sectional study was conducted on 30 formalin-fixed adult human cadaveric hearts in the Department of Anatomy, Regional Institute of Medical Sciences, Imphal, from July 2025 to March 2026 after Institutional Ethics Committee approval. Coronary arteries were dissected to evaluate the position of the coronary ostia relative to the sinotubular junction, branching pattern, coronary dominance, myocardial bridging, and anomalies. The length of the left coronary artery (LCA) trunk was measured using a digital Vernier caliper, and data were analyzed using IBM statistical package for the social sciences (SPSS) statistics version 26.

Results The LCA ostium was located below the sinotubular junction in 86.7% of hearts, while the right coronary artery (RCA) ostium was below the junction in 80.0%. The LCA exhibited bifurcation in 60.0%, trifurcation in 26.7%, and tetra- and pentafurcation in 6.7% each. The sinoatrial nodal, conus, posterior interventricular, and right marginal arteries arose from the RCA in 96.7%, 86.7%, 90.0%, and 30.0% of specimens, respectively. Myocardial bridging was present in 20.0%, and a third coronary artery in 3.3%. The mean LCA trunk length was 9.34±3.39 mm. Right coronary dominance was observed in 86.7% of hearts.

Conclusions Coronary arteries exhibited significant anatomical variability, particularly in the location of the coronary ostia and branching pattern of the LCA. These findings provide clinically relevant anatomical data that may improve the safety and accuracy of coronary imaging and surgical and interventional procedures.