Double non coronary aortic sinuses: an autopsy case finding showing the arterial variation / Senos aórticos dobles, no coronarios: un caso de autopsia que demuestra la variación arterial

We report a case of variant origin of the right coronary artery from the left posterior aortic sinus. This was observed routinely during a medico legal autopsy of a 58 year old male who died in a road traffic accident. Initially it was believed that the right coronary artery was absent since there was no obvious right coronary artery ostium from the anterior aortic sinus. However it was found later that the right coronary ostium was present just beside the left coronary ostium in the left posterior aortic sinus and the right coronary artery was arising from the left posterior aortic sinus. The right coronary artery had an intramural course between the aorta and pulmonary trunk, which is considered as very dangerous and life threatening. We believe that the present case report will be enlightening to the cardiologist and cardiothoracic surgeon. It is also true that the conduction of medico legal autopsies of coronary arteries is important for the medico legal resolution.

Se presenta un caso de variación de origen de la arteria coronaria derecha desde el seno aórtico posterior izquierdo. Esto se observó de forma rutinaria durante una autopsia médico-legal de un hombre de 58 años que murió en un accidente de tránsito. Inicialmente se creía que la arteria coronaria derecha estaba ausente ya que no había un ostium observable desde el seno aórtico anterior. Sin embargo, se descubrió más tarde que el ostium de la arteria coronaria derecha estaba presente justo al lado del ostium de la arteria coronaria izquierda en el seno aórtico posterior izquierdo y la arteria coronaria derecha se originaba del seno aórtico posterior izquierdo. La arteria coronaria derecha presentó un recorrido intramural entre la aorta y el tronco pulmonar, que se considera como muy peligroso y potencialmente mortal. Creemos que el presente trabajo será esclarecedor para el cardiólogo y el cirujano cardiotorácico. También consideramos que el conocimiento de la anatomía de las arterias coronarias es importante durante el desarrollo de la autopsia médico-legal para lograr alcanzar una correcta resolución del proceso medicolegal.

Morphometry of the intercommissural distances and other structures of the aortic valve of bovine heart.

The morphometry of the intercommissural distances and their relation with other structures of the aortic valve of bovine heart was carried out. A total of 32 apparently healthy bovine hearts of indigenous cattle of both sexes (50% male and 50% female), 2-4 years of age, weighing 500 to 800 gms were used in this study. The external intercommissural distances were higher in all cusps of the valve compared to the internal intercommissural distances. The internal intercommissural distance was larger in the RC sinus in case of male animals followed by that of the LC and NC sinus. The mean external intercommissural distances were 34.67+/-3.40, 34.40+/-3.64 and 34.97+/-4.37 mm and the internal intercommissural distances were 21.60+/-4.21, 21.20+/-4.70 and 20.67+/-4.06 mm for LC, RC and NC respectively. Analyzing the internal intercommissural distance, value in the LC sinus was higher followed by the RC and the NC but this variation was non-significant. In regard to the position of the coronary ostia, there were two coronary ostia, the right coronary ostium present in the RC sinus and the left coronary ostium in the LC sinus respectively and the right coronary ostium was supracommissural in position in bovine heart. Data about the morphometrical analysis of intercommissural distances and the position of the coronary ostia of the aortic valve facilitate the knowledge of manufacturing bovine tissue valve as well as those might be involved in valve replacement in human.

Development of the coronary arteries in staged human embryos: the Paris embryological collection revisited

Twenty seven human embryos from stages 15 to 23 (postsomitic period), belonging to the collection of the "UFR Biomédicale des Saints-Peres, Université René Descartes Paris V", were studied. Details of the aorticopulmonary cleavage were analysed specially aortic valve development and origin of the coronary artery. At stage 18 the aortic valve was clearly distinguished (cup-shaped) presenting semilunar valves and aortic sinus (Valsalvae); at this stage the left coronary artery was detected in 66.7 per cent of the cases as an endothelial epicardial invagination. At stage 19, the left and right coronary arteries were detected simultaneously in 100 per cent of the cases. At stage 20, the coronary arteries showed greater structural complexity with a coat of mesenchymal cells. These results agree with previous data from different embryological collections. These findings suggest that the left coronary artery has a tendency to develop earlier than the right. We found no evidence of the coronary origin from the aortic umen. This work provides additional information about the embryological development of the heart, obtained from the analyses of a French collection of human embryos

Relación entre ostios coronarios y senos aórticos / Relation between coronay ostium and aortic sinus

La descripción topográfica de los ostios coronarios es de gran importancia anátomo-clínica, por el uso de ellos en la cateterización exitosa en una arteriografía coronaria selectiva (Sones 1962). En ocasiones las variaciones de ubicación de los ostios con respecto a los senos, crea dificultades técnicas y requiere una mayor manipulación del cateter o bien el uso de catéteres especiales (Amplatz et al., 1967). Se analiza la disposición de los ostios de las arterias coronarias en 40 individuos chilenos, cuyas edades fluctúan entre 18 y 73 años, siendo 34 del sexo masculino y 6 del sexo femenino. Las muestras fueron obtenidas en el Servicio de Anatomía Patológica, Medicina Legal y Unidad de Anatomía Normal, Universidad de la Frontera, Temuco. Las variables analizadas son: número de ostios, diámetro de ellos, relación con el seno aórtico respecto al plano vertical y plano horizontal. Los resultados obtenidos son comparados con los realizados por otros autores como Banchi (1904); Rocha Lagoa (1928); Testut y Latarjet (1958); James (1961); Paulin (1964) y Vladover (1972)