Ex vivo and in vivo coronary ostial locations in humans

Abstract

Purpose Knowledge of the normal in vivo distribution and variation of coronary ostial locations is essential in the planning of various interventional and surgical procedures. However, all studies to date have reported the distribution of coronary ostia locations only in cadaver hearts. In this study, we sought to assess the distribution of coronary ostial locations in patients using cardiac dual-source computed tomography (CT) and compare these values to those of human cadaveric specimens. Methods Measurements of the coronary ostia location were performed in 150 patients undergoing dual-source CT and in 75 cadavers using open measurement techniques. All 150 patients had a normal aortic valve function and no previous cardiac intervention or surgery. The location of the right and left coronary origin in relation to the aortic annulus and the height of the sinus of Valsalva were measured. Conclusions This study provides data of normal coronary ostial origins and demonstrates signiWcant diVerences between in vivo and ex vivo measurements regarding the right coronary ostium. The observed large variations of coronary ostia origins emphasize the importance of considering such anatomic variations in the development of treatments. Results

Variant high origin of both right and left coronary arteries from the ascending aortic wall

“…Sudden death also has been reported which is mainly due to impairment in the diastolic coronary artery flow. Knight et al (6) has found the mean ostial positions in relation to the aortic annulus were 17 mm and 15.3 mm for the right and left coronary ostia respectively (whereas in our study, it is 18 mm-right and 17 mm-left).…”

Automated Quantitative 3-Dimensional Modeling of the Aortic Valve and Root by 3-Dimensional Transesophageal Echocardiography in Normals, Aortic Regurgitation, and Aortic Stenosis

“…5 The measurement of annulus to coronary ostia distance on 2D planes derived from volume data, such as CT, has shown discrepancy with ex vivo measurements. 18 This may be because of the differing 2D techniques (Figure VI in online-only Data supplement), which emphasizes the advantage of direct 3D measurement used in our study. The minimal distance between the leaflet tips and coronary ostia can also be measured that may help predict potential complications of calcium embolization during transcatheter AV replacement.…”

Total ellipse of the heart valve: the impact of eccentric stent distortion on the regional dynamic deformation of pericardial tissue leaflets of a transcatheter aortic valve replacement

“…Both circular and eccentric orifices were constructed such that the cross-sectional orifice areas were the same. Aortic annulus models were mated with a custom-built idealized acrylic aortic root model based on clinical measurements [27,28] consisting of a straight rigid ascending aorta section developing into an axisymmetric sinus region (figure 2a,b). Valve deployment was carried out as per the instructions of use.…”