Shepherd' Crook right coronary artery in an octagenerian: A case report and literature review

Right coronary artery after origin from right coronary sinus traverses horizontally to run in right atrioventricular groove till the crux of the heart where it divides into posterior descending artery and posterior left ventricular branch. When the right coronary artery after its origin takes an acute high take off from the ostium and then abruptly descends down making a hairpin loop to run in the right atrioventricular groove, it is known as Shepherd's crook right coronary artery which is extremely rare to encounter in routine clinical practice. This interesting coronary artery deformity has great significance per se so far as the coronary physiology and intervention is concerned. We present a case of Shepherd's crook right coronary artery in the most elderly patient of 84 years of age in world literature and detailed review of this peculiar anatomy. Review literature about Shepherds Crook deformity is yet not there in the literature except some case reports and this review article will be providing the interventional cardiologists a detailed insight into the right coronary ischemia secondary to this interesting anomaly.