Cardiovascular System - Coronary Circulation Development
The coronary circulation provides the blood supply to the heart required for the normal muscular function. From recent mouse studies, the origin of this specialised vasculature is from the sinus venosus.
Development of the heart and vascular system begins very early in mesoderm both within (embryonic) and outside (extra embryonic) the embryo. Vascular development therefore occurs in many places, the most obvious though is the inflow and outflow in the forming heart, which grows rapidly creating an externally obvious cardiac "bulge" on the early embryo.
The coronary circulation an important medical topic postnatally. Blockage and failure of this system leads initially to angina, continued ischemia leads to hypoxic death of cardiac muscle and myocardial infarction, a heart attack.
For general information about blood vessel development, see Blood Vessel Development and note that blood vessels also occurs outside the embryo in the extra-embryonic mesoderm of the yolk sac (vitelline) and in the villi of the placenta.
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Some Recent Findings
(More? recent references)
Coronary Vessel Anatomy
Human Coronary Vessel Development
An early research paper identified development of the coronary arteries in the embryonic human heart using embryos from the Carnegie Collection.
- six sinuses of the embryonic great arteries
- Carnegie Embryological Collection coronary vasculature in 351 staged, serially sectioned human embryos (Carnegie stages 9 to 23).
stage 18 - connection of the proximal coronary arteries to the aorta.
Mouse Coronary Vessel Development
Image showing changes in venous (blue) and arterial (red) marker expression during coronary development; black indicates dedifferentiated venous cells.
There are several abnormalities associated with the anatomical variation in vascular pattern of vessels including abnormal origins and absence.
Anomalous Left Coronary Artery from the Pulmonary Artery
Anomalous origin of left coronary artery from pulmonary artery (ALCAPA) is a rare malformation (incidence of 0.25–0.50% )in children with abnormal cardiac development leading to a mortality rate of 90% in unoperated infants. There are a variety of surgical repair techniques including: direct aortic implantation, a modified tubular extension technique, and an intrapulmonary baffling technique.
Anomalous Right Coronary Artery from the Left Sinus
Anomalous Single Coronary Artery from the left sinus of Valsalva
This abnormality has been reported as occurring with an absence of the right coronary artery. 
Ectopic Origin of the Right Coronary Artery
The right coronary artery arises outside the borders of the right coronary sinus, the most common locations are the left sinus (either the anterior, superior portion) or directly from the left main coronary artery. Anterior displacement is the most prevalent anatomical variant. Also very rarely arising from other anatomical locations including; the non-coronary (posterior) sinus, left anterior descending coronary artery, left circumflex coronary artery, pulmonic artery, and the descending aorta. Clinically seen as cardiac ischemia and arrhythmia.
Anomalous Sinus Node Artery
The sinus node artery normally originates from the proximal segment of the right coronary artery, left circumflex artery, or from both. With anomalous sinus node artery this vessel can originate from the left anterior descending artery.
Congenital Sinus of Valsalva Aneurysm
This aneurysm, a blood-filled dilatation, arises due to a localized weakness of the wall of the sinus bulging that may rupture into an adjacent cardiac chamber, forming an aortocardiac fistula.
- ↑ 1.0 1.1 Kristy Red-Horse, Hiroo Ueno, Irving L Weissman, Mark A Krasnow Coronary arteries form by developmental reprogramming of venous cells. Nature: 2010, 464(7288);549-53 PMID:20336138
- ↑ Nynke M S van den Akker, Vincenza Caolo, Lambertus J Wisse, Patricia P W M Peters, Robert E Poelmann, Peter Carmeliet, Daniël G M Molin, Adriana C Gittenberger-de Groot Developmental coronary maturation is disturbed by aberrant cardiac vascular endothelial growth factor expression and Notch signalling. Cardiovasc. Res.: 2008, 78(2);366-75 PMID:18093989
- ↑ G M Hutchins, A Kessler-Hanna, G W Moore Development of the coronary arteries in the embryonic human heart. Circulation: 1988, 77(6);1250-7 PMID:3286038
- ↑ K M Cherian, S Bharati, S G Rao Surgical correction of anomalous origin of the left coronary artery from the pulmonary artery. J Card Surg: 1994, 9(4);386-91 PMID:7949665
- ↑ Tiina Ojala, Jukka Salminen, Juha-Matti Happonen, Jaana Pihkala, Eero Jokinen, Heikki Sairanen Excellent functional result in children after correction of anomalous origin of left coronary artery from the pulmonary artery--a population-based complete follow-up study. Interact Cardiovasc Thorac Surg: 2010, 10(1);70-5 PMID:19808708 | Interact Cardiovasc Thorac Surg.
- ↑ Tanyanan Tanawuttiwat, Tasma Harindhanavudhi, Dinker Trivedi Anomalous single coronary artery with absent right coronary artery diagnosed with the aid of 64-slice multidetector computed tomographic angiography. Tex Heart Inst J: 2009, 36(4);362-3 PMID:19693319 PMC2720291
- ↑ Pallavi Solanki, Christine Gerula, Preet Randhawa, Michael Benz, James Maher, Bunyad Haider, Marc Klapholz, Jack Palmaro, Diane Alfano, Edo Kaluski Right coronary artery anatomical variants: where and how? J Invasive Cardiol: 2010, 22(3);103-6 PMID:20197575 | J Invasive Cardiol.
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