Özet:

Abstaract Objective: Having detailed information about normal coronary anatomy and its different variations provides great advantage in determining the technique to be used during percutaneous revascularization or operation. There are a lot of studies related to the coronary artery dominance in the literature, very little data related to the superdominant right coronary artery (RCA) is available. In this study, we aimed to describe anatomical features and the diameters of the coronary arteries in the presence of superdominant RCA. Method and findings: We evaluated 3454 coronary angiographies retrospectively, which were implemented in our hospital according to the diagnoses with recognized or suspicious coronary artery disease (CAD) between 2004 December and 2012 January. The cases in which the left ventricular apex is supplied by posterior descending artery (PDA) that is a branch of the right coronary artery has been deemed as superdominant right coronary artery. In 312 (9%) of 3454 patients whose angiographies had been examined, the right coronary artery was determined as superdominant. Coronary angiographies of the 312 patients whose right coronary arteries are superdominant have been evaluated. Coronary artery diameters and left main coronary artery (LMCA) lengths of the 100 patients having superdominant right coronary and showing normal coronaries in coronary angiography have been measured. Right coronary artery proximal, mid and distal diameters were measured approximately 4.45±0.93, 4.20±0.99 and 3.50±0.80, respectively. Diameter of LMCA was measured approximately 4.72±0.88, 4.70±0.89 and 4.72±0.88 mm in proximal, mid and distal, respectively and average LMCA length was measured 12.05±3.67 mm. Average LAD diameter was measured 3.64±0.67, 3.01±0.72 and 2.07±0.34 in the proximal, the mid and the distal, respectively and the average circumflex artery (CXA) diameter was measured 2.92±0.66 and 1.88±0.41 in the proximal and the distal, respectively. The correlation between LMCA proximal diameter and RCA proximal diameter was found as significantly meaningful.  Also, it was determined that the difference between the averages of the LAD and RCA tapering indexes had been statistically significant. Conclusion: RCA proximal and distal segment diameters in the presence of the super-dominant right coronary artery are significantly larger compared to LAD and CX diameters. Antegrade tapering is not sufficient for RCA. The length of the LMCA has increased compared to the previous study data. As expected, LAD artery is underdeveloped in these cases, terminates before reaching to the apex and equally terminates in the distal with a diagonal artery that is developed frequently in the mid region. Antegrade tapering is distinct for LAD artery. In these patients, intermediate artery frequency is over the conventional rates and myocardial bridge association is lower. Sinoatrial node artery and conus branch take their origins from the right coronary artery over the conventional values. 

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