Study on topographic relations of coronary ostia with sinotubular junction, commissure of aortic leaflets and aortic sinuses in human cadavers

The coronary angiography can be performed successfully by having knowledge on the location and level of coronary ostia. The morbidity and mortality of invasive procedures may be reduced by studying the topographical relations of coronary orifices. The present study is undertaken

To observe the relations of coronary ostia to Sinotubular junction.

The present study was done on 49 formalin fixed human cadaveric hearts and the position of coronary ostia with respect to sinotubular junction and commissure was noted. The distance between coronary ostia and the bottom of the aortic sinus was measured.

It was observed that the incidence of various locations of coronary ostia in relation to STJ was in 44 (89.8%) specimens right coronary ostium was below STJ and in 26 (53.1%) specimens left coronary ostium was at STJ which was statistically significant (p-value<0.0001). The distance of right coronary ostia from its right and left commissures was 9.73mm and 14.55 mm respectively. The distance of left coronary ostia from its right and left commissures was 11.74mm and 11.27 mm respectively. The right coronary ostium was deviated to right commissure which is towards right posterior aortic sinus and the left coronary ostium was almost near the centre of aortic sinus which was statistically significant (p-value<0.001). The mean distance of right coronary ostium from the bottom of aortic sinus was (14.1mm) greater than left coronary ostium (12.7mm) which was statistically significant (p-value=0.001).

One of the difficult challenges to cardiac surgeons is selective insertion of catheter tips which requires awareness on anomalous coronary ostia.