RESUMEN
Introduction: Coronary artery disease is responsible for 70% cases of sudden cardiac deaths. Small coronaryostia may cause significant difficulty in canulation of it during diagnostic and therapeutic procedures. Highorigin of coronary arteries increases risk of myocardial ischaemia and sudden death. Considering thesesignificance of variations of coronary ostia in cardiac procedures, detailed study was undertaken so it would beof use to cardiologists and interventional radiologists.Material and Methods: Sample size for the study comprised of 50 human cadaveric heart specimens. Dissectionmethod was adopted.Observation and Results: In anterior aortic sinus, 41 specimens had single ostium, while 09 specimens showedtwo separate ostia. The mean of ostium diameter of right coronary artery was found to be 2.84 mm with astandard deviation (S.D.) of +0.85 mm. The mean distance of main ostium of right coronary artery fromsupravalvular ridge was found to be 1.23 mm. with a S.D. of +0.32 mm. In case of accessory ostia in anterioraortic sinus, the mean diameter was found to be 1.32 mms. with a S.D. of +0.20 mms. The mean distance of theseostia from supravalvular ridge was found to be 1.16 mms. with a S.D. of +0.17 mms. In left posterior aortic sinus,49 specimens had single ostium, while 01 specimen had two separate ostia. This ostium was 0.8 mms. indiameter at a distance of 02 mms. below from supravalvular ridge. The mean of ostium diameter of left coronaryartery was found to be 3.31 mm with a S.D.of+0.52 mm. The mean distance of main ostium of left coronary arteryfrom supravalvular ridge was found to be 1.40 mm. with a S.D. of +0.27 mm.Conclusion: the study provides data on coronary morphometry and topography. It provides basis for understandingthe normal variants for determining incidence of anomalies and for evaluating value of screening of suchanomalies.
RESUMEN
The right and left coronary artery arises from the anterior and left posterior sinus of Valsalva respectively. Aortic root is an important area for various interventional diagnostic and surgical procedures for cardiologist and radiologist which comprises of the bulbar aortic sinus and the proximal ascending aorta. 50 cadaveric human heart specimens (25 male and 25 female) were used by dissection method. It has been observed that the mean diameter of left coronary ostium is more than that of right coronary ostium. The mean diameter of left coronary ostium in male is 4.37mm ± 0.84 and in female it is 4.16mm ± 0.67. On the contrary, in case of right coronary ostium the mean diameter were 3.04mm ± 0.76 and 3.14mm ± 0.70 in male and female respectively. In 18% specimens multiple openings were observed in anterior aortic sinus. However, in 4% specimen anterior aortic sinus with no openings were also observed. Multiple openings were also seen in left posterior aortic sinus in 4% specimen. No openings were observed in the pulmonary sinuses and the right posterior aortic sinus. Knowledge of the level of ostia is very important to avoid difficulties during various diagnostic and surgical procedures, hence, to extract extra information regarding these issues, study was also extended to observe the level of ostia; and in this study right coronary ostium was found below Supravalvular Ridge (SVR) in 78% specimen, at SVR in 10% specimen and above SVR in 12% specimen. The left coronary ostium was found below SVR in 68% cases, at SVR in 16% cases and above SVR in 16% cases.
RESUMEN
This study was carried out to investigate the morphometric parameters and variations of coronary ostia in the hearts of adult human cadavers and coronary angiographs. The hearts of 60 adult human cadavers and 400 coronary angiographs were used in this study. The root of the aorta was carefully dissected to clear aortic sinuses, coronary ostia, and sinutubular junction (STJ). Number, locations, internal diameter distance between coronary ostia and their corresponding STJ, sinus bottom, and valve commissures were investigated. The anterior aortic sinus (AAS) revealed a single ostium for right coronary artery (RCA) in 77.5% of male and 80% of female hearts. This ostium gave a common origin for RCA and third coronary artery (TCA) in 15% of male and 20% of female hearts. However, two separate ostia for RCA and TCA origin were seen in 20% of male and 15% of female hearts. Moreover, three ostia were seen in one male and one female hearts within AAS. Meanwhile, the left posterior aortic sinus showed a single ostium for left coronary artery (LCA) in 97.5% of male and 95% of female hearts and two ostia in one male and one female hearts. The ostia were commonly seen below STJ and less commonly were observed above STJ. The distance between the bottom of aortic sinus and LCA ostium was longer than that of RCA. The internal diameter of RCA ostium was significantly (P<0.05) narrower than that of LCA but with no significant sex difference. Moreover, anomalous of coronary ostia was observed in seven out 400 angiographs and in two cadaveric hearts. Knowledge the morphometric parameters and anatomical variations of coronary ostia helps the cardiac surgeons to overcome the possible difficulties that could occur during surgical and radiological coronary interventions.