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Dual origins

Separate development – bi- partite origins

Marriage of convenience

Epicardial Component

Embryology of Coronary Stems. Both subepicardial CAs and veins are extracardiac in origin, deriving from epicardial cells (13, 14). Their development begins with the formation of a plexus-like vasculature located in the subepicardium, which invades the myocardium and develops small vessels and capillaries.

At the time of spongy myocardium, intramural blood supply derives directly by the ventricular cavities, whereas later, at the time of myocardial compaction, vascularization originates from the subepicardial network.

Embryology of Coronary Stems. Both subepicardial CAs and veins are extracardiac in origin, deriving from epicardial cells (13, 14). Their development begins with the formation of a plexus-like vasculature located in the subepicardium, which invades the myocardium and develops small vessels and capillaries.

This source of blood to the primitive spongy myocardium disappears

Figure 12. Embryology of the myocardium. (a) Spongy myocardium from a mature fog with blood supply deriving directly from the endocardium of the ventricular cavities. (b) The myocardium of a fetal chick heart becomes compact, with blood supply deriving from the subepicardial vasculature. From de la Cruz et al. (13).
Thiene, G et al Coronary Arteries: Normal Anatomy With Historical Notes and Embryology of Main Stems Front. Cardiovasc. Med., 31 May 2021

 

Origin of coronary arterial stems from the peritruncal epicardial ring. (a) From Bogers et al. (17). (b) From de la Cruz et al. (13).
Thiene, G et al Coronary Arteries: Normal Anatomy With Historical Notes and Embryology of Main Stems Front. Cardiovasc. Med., 31 May 2021

with the myocardial compaction

Coronary Artery Left Anterior Descending Artery LAD Mustache
Normal Angiogram
Ashley Davidoff MD
60M HOCM Anomalous Origin of the Right Coronary Artery From the Left Coronary Artery Sinus
Ashley Davidoff
thecommonvein.net
Anomalous Origin of The Right Coronary Artery from the Left Coronary Artery Cusp
60 year old male with a history of MI with LAD stent. Coronary angiogram suggested anomalous origin of the right coronary artery
CTA of the coronaries shows anomalous origin of the RCA from the left coronary cusp with inter-arterial course. There is narrowing of the proximal RCA as it courses between the PA and aorta
Ashley Davidoff MD
MRI showing anomalous RCA from left coronary sinus with inter-arterial course.
origin Wiki Commons
44647b05
Anomalous coronary artery origin in a neonate with TOF. Oblique axial image from a whole-heart 3D SSFP acquisition shows anomalous origin of the left anterior descending (LAD) coronary artery from the right coronary artery (RCA). Note that the left anterior descending coronary artery crosses the RVOT. A = aorta, br = branch, LCX = left circumflex coronary artery.
(Frank L et al Cardiovascular MR Imaging of Conotruncal Anomalies Radiographics)
Anomalous Origin of The Right Coronary Artery from the Left Coronary Artery Cusp
60 year old male with a history of MI with LAD stent. Coronary angiogram suggested anomalous origin of the right coronary artery
CTA of the coronaries shows anomalous origin of the RCA from the left coronary cusp with inter-arterial course. There is narrowing of the proximal RCA as it courses between the PA and aorta
Ashley Davidoff MD
Anomalous Origin of The Circumflex Coronary Artery from the Right Coronary Artery Cusp CT
Right Coronary Angiogram shows anomalous origin of the Circumflex from the Right coronary cusp. This is the most common anomaly of the coronary arteries
Ashley Davidoff MD

 

Links and References

Thiene, G et al Coronary Arteries: Normal Anatomy With Historical Notes and Embryology of Main Stems Front. Cardiovasc. Med., 31 May 2021