Rca heart
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Summary
10 papers analyzed
These studies suggest that the right coronary artery (RCA) exhibits anatomical variations, can be effectively treated with robotic surgery, and has specific patterns of intimal thickening and branching that are important for diagnosis and treatment.
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Right Coronary Artery (RCA): Anatomy, Variability, and Clinical Implications
RCA Anatomy and Morphometric Analysis
The right coronary artery (RCA) is a critical component of the coronary circulation, supplying blood to various parts of the heart. Anatomical studies have shown significant variability in the RCA's structure and branching patterns. In a study of 221 fresh hearts, the RCA's proximal segment had an average diameter of 3.42 mm, while at the acute angle of the heart, it measured 2.9 mm. The RCA typically terminates between the crux cordis and the left margin in 75.6% of cases, and the posterior interventricular artery (PIA) reaches the inferior third or apex in 67.4% of specimens. Similar findings were observed in a study of Vietnamese cadavers, where the RCA had a mean diameter of 4.21 mm and a length of 122.5 mm, terminating between the crux and left border in 72% of cases.
RCA Variability and Clinical Implications
The RCA's anatomical variability has significant clinical implications, particularly in surgical procedures and the management of coronary artery disease (CAD). For instance, the sinoatrial node artery (SNA) originates from the RCA in 60.6% of cases, while in 34.9%, it arises from the circumflex artery (CxA). This variability can affect hemodynamic procedures and cardiac surgeries, necessitating a thorough understanding of individual anatomical differences .
RCA in Non-Human Primates
Studies on non-human primates, such as Cercopithecus aethiops, have shown that the RCA's anatomy closely resembles that of humans. The RCA orifice is usually situated in the middle part of the right aortic sinus, and the long RCA type is the most frequent finding. This similarity underscores the potential of using non-human primates as models for studying human coronary artery diseases.
RCA and Atherosclerosis
Atherosclerosis is a major cause of cardiovascular disease, and the RCA is often affected due to its anatomical features. A study examining the distribution of intimal and medial thickening in human RCAs found that 71% of proximal sections displayed eccentric intimal thickening, primarily on the myocardial side of the artery. This thickening is believed to result from shear and tensile stresses at arterial bifurcations, leading to atherosclerosis.
Robotic Beating-Heart TECAB for RCA Disease
Robotic totally endoscopic coronary artery bypass (TECAB) has emerged as a feasible technique for treating isolated RCA disease. In a series of 16 patients, robotic beating-heart TECAB was successfully performed without conversion to sternotomy or mini-thoracotomy, demonstrating its potential as a minimally invasive surgical option. The mean procedure time was 223 minutes, and no mortality was observed at a mean follow-up of 20.6 months.
Ex-Vivo Vascular Bioreactor for RCA Studies
Ex-vivo systems have been developed to study the viability of coronary arteries, including the RCA. In one study, porcine RCAs were cultured in a vascular bioreactor, maintaining their physiological morphology for up to 9 days. This model provides a valuable tool for testing vascular therapies and devices, bridging the gap between in-vitro and in-vivo studies.
Conclusion
The right coronary artery exhibits significant anatomical variability, which has important implications for clinical practice, particularly in surgical procedures and the management of coronary artery disease. Understanding these variations is crucial for improving patient outcomes and advancing cardiovascular research.
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