Coronary Artery Variations in Dextrocardia with Situs Inversus: Two Cadaveric Case Reports

Cadaveric studies on the anatomy of the coronary artery distribution in dextrocardia with situs inversus are rarely documented in literature due to the rarity of the condition.
These two case reports describe the anatomical variations in the coronary circulation in two male cadavers with dextrocardia and situs inversus. The cadavers were those donated to the Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka for Medial education and research. There are based on two independent incidental findings of dextrocardia with situs inversus during routine student dissection over 07 years. Special focus was placed on documenting the course and patterns of the coronary artery branches to detect any variations. In the first case, a rare variation was observed as a trifurcated right-sided left coronary artery with a ramus intermedius branch. The second case revealed a right-sided left coronary artery with tetrafurcation, accompanied by myocardial bridging. Another noteworthy finding was a slight alteration in the aortic sinus configuration, deviating from the typical mirror image seen in situs inversus with dextrocardia. Morphological differences were also noted in the external diameters of the right-sided left coronary artery branches. Understanding these coronary vessel anomalies and the myocardial bridging in dextrocardia with situs inversus is critical for optimizing therapeutic and surgical interventions. This study adds evidence to the scientific literature on morphological variations that can impact clinical outcomes.