Anatomic Variability of Coronary Ostia in Adult Human Cadaveric Hearts

Abstract

In the light of increased incidence of coronary arterial diseases, knowledge of the variations in the number and location of coronary ostia is essential in the planning of various interventional and surgical procedures on the coronary arteries as well as aortic valve replacements. Aim: To investigate the variations in the origin, number, size and location of coronary ostia in relation to aortic leaflets. Methods: Eighty adult human cadaveric hearts with great vessels in situ were studied for coronary ostia. Results: 78 hearts had tricuspid aortic valve and two hearts had bicuspid aortic valve. Anomalous origins of right coronary artery from the left posterior aortic sinus in one heart and the left coronary artery from the noncoronary sinus in another heart were noted. Both right and left coronary arteries arose from the anterior aortic sinus in two hearts with bicuspid aortic valve. Single right coronary ostium was seen in 63 hearts (78.75%), two right coronary ostia were found in 14 hearts (17.5%), three right coronary ostia were found in two hearts (2.5%), and four were found in one heart(1.25%). The left coronary ostium was single in all hearts. The mean diameter of right coronary ostium (RCO) was 3.17±0.87 mm and of the left coronary ostium (LCO) was 4.1±0.83 mm. The relation of the right and left coronary ostia to the sinu-tubular junction, to the bottom of the related sinus and to the commissures was also analyzed in detail. Conclusion: This study provides data on normal coronary ostial morphometry and topography and there were significant differences in the number of right coronary ostia than of the left coronary ostium. The observed large variations of coronary ostial position in relation to the sinu-tubular junction and to the bottom of the aortic sinus emphasize the importance of considering such anatomic variations in the development of treatments for coronary artery occlusion.

Anatomical and radiological angiographic study of the coronary ostia in the adult human hearts and their clinical significance

“…Knowledge of the anatomical level of coronary ostia with reference to STJ provides great help in many radiological and surgical cardiovascular procedures [ 13 ], where the proximity of coronary ostia to the aortic annulus and valve leaflets could increase the risk of coronary ostial closure during the operation of aortic valve replacement [ 14 ]. In this study, the site of the coronary ostia was observed below STJ in 80% of RCA, in 73.3% of LCA and in 85.7% of TCA with no significant sex difference.…”

“…In this study, the site of the coronary ostia was observed below STJ in 80% of RCA, in 73.3% of LCA and in 85.7% of TCA with no significant sex difference. Similarly, a higher incidence of coronary ostia below STJ was recorded than that at or above STJ levels; in 90% of RCA and 73.3% of LCA ostia [ 10 ]; in 65% of RCA and 52.5% of LCA [ 13 ]; in 78% of RCA and 68% of LCA ostia [ 8 ]; in 63% of RCA and 44% of LCA [ 15 ]; in 73.3% for all [ 9 ]; in 78% of RCA and 58% of LCA [ 16 ]; in 90% of RCA and 80% of LCA ostia [ 2 ]; in 75% of RCA and 85% of LCA [ 17 ]; in 60% of RCA and 42% of LCA [ 3 ]; and below STJ in 89.5% of RCA and 80% of LCA and in 6.7% of RCA and 15.2% of LCA at the level of STJ and in 3.8% of RCA and 4.8% of LCA above STJ [ 2 ].…”

“…Similarly, 10% of RCA and 16% of LCA ostia were seen at the level of STJ [ 8 ]. However, a higher incidence of ostia was reported at or above the level of STJ, 56.6% of RCA and 52.2% of LCA ostia at STJ and in 16.6% of RCA and 17.7% of LCA ostia above STJ [ 18 ]; 71% and 19% of RCA and 22% and 60% of LCA ostia respectively [ 19 ]; 24% of RCA and 39% of LCA at level of STJ and in 11% of RCA and 9% of LCA above STJ [ 13 ]; 26% of RCA and 37% of LCA above STJ [ 15 ]; 13% of RCA and 29% of LCA above STJ [ 16 ]; 10% of RCA and 20% of LCA ostia above STJ [ 4 ]; 28% of RCA and 40% of LCA above STJ [ 3 ]. Meanwhile, the ostium of RCA was seen below STJ in 16% and above in 2% of the cases.…”

“…Knowledge of the measurements of ostial height will help radiologists and clinicians during performing angiography and angioplasty [ 2 ]. Also, the main distance between the RCA ostia and the bottom was 11.73±2.9 mm and that of LCA was 12.7±2.1 mm [ 13 ]. The finding differences in the literature could be due to the arched form of STJ [ 2 ].…”

Analysis of the total lumen of circumflex branch of l eft coronary artery in norm and in myocardial infarction

“…DOI -http://dx.doi.org/10.14300/mnnc.2019.14094 (In Russ.) Б ольшая часть современных публикаций посвящена описанию классических морфометрических показателей венечных артерий (внутреннего и наружного диаметра, длины сосудов, бифуркационного угла) [1]. Дана характеристика особенностям взаимоотношений артериального и венозного русел сердца [2,3].…”