Skip to main content

Advertisement

SpringerLink
Log in

Ex vivo and in vivo coronary ostial locations in humans

  • Original Article
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

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.

Results

Mean ostial locations at CT were 17.0 (±3.6) mm and 15.3 (±3.1) mm for the right and left coronary ostia, with large variations of both sides (right: 10.4–28.5 mm; left: 9.8–29.3 mm). In cadavers, mean locations were 14.9 (±4.3) mm [5–24 mm] for right and 16.0 (±3.6) mm [9–24 mm] for left coronary ostia. Comparison of CT and cadaver data showed statistically significant differences for right (P < 0.0001) but not left (P = 0.1675) coronary ostia.

Conclusions

This study provides data of normal coronary ostial origins and demonstrates significant differences 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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Alkadhi H, Scheffel H, Desbiolles L, Gaemperli O, Stolzmann P, Plass A, Goerres GW, Luescher TF, Genoni M, Marincek B, Kaufmann PA, Leschka S (2008) Dual-source computed tomography coronary angiography: influence of obesity, calcium load, and heart rate on diagnostic accuracy. Eur Heart J 29(6):766–776

    Article  PubMed  Google Scholar 

  2. Babaliaros V, Block P (2007) State of the art percutaneous intervention for the treatment of valvular heart disease: a review of the current technologies and ongoing research in the field of percutaneous valve replacement and repair. Cardiology 107(2):87–96

    Article  PubMed  Google Scholar 

  3. Berdajs D, Lajos P, Turina M (2002) The anatomy of the aortic root. Cardiovasc Surg 10(4):320–327

    Article  PubMed  Google Scholar 

  4. Boudjemline Y, Bonhoeffer P (2002) Steps toward percutaneous aortic valve replacement. Circulation 105(6):775–778

    Article  PubMed  Google Scholar 

  5. Budoff MJ, Achenbach S, Blumenthal RS, Carr JJ, Goldin JG, Greenland P, Guerci AD, Lima JA, Rader DJ, Rubin GD, Shaw LJ, Wiegers SE (2006) Assessment of coronary artery disease by cardiac computed tomography: a scientific statement from the American Heart Association Committee on Cardiovascular Imaging and Intervention, Council on Cardiovascular Radiology and Intervention, and Committee on Cardiac Imaging, Council on Clinical Cardiology. Circulation 114(16):1761–1791

    Article  PubMed  Google Scholar 

  6. Cavalcanti JS, de Melo NC, de Vasconcelos RS (2003) Morphometric and topographic study of coronary ostia. Arq Bras Cardiol 81(4):359–362, 355-358

    Article  PubMed  Google Scholar 

  7. Diamond GA, Forrester JS (1979) Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med 300(24):1350–1358

    Article  PubMed  CAS  Google Scholar 

  8. Du Bois D, Du Bois EF (1989) A formula to estimate the approximate surface area if height, weight be known 1916. Nutrition 5(5):303–311 (discussion 312–313)

    PubMed  CAS  Google Scholar 

  9. Flecher EM, Curry JW, Joudinaud TM, Kegel CL, Weber PA, Duran CM (2007) Coronary flow obstruction in percutaneous aortic valve replacement an in vitro study. Eur J Cardiothorac Surg 32(2):291–294

    Article  PubMed  Google Scholar 

  10. Hendel RC, Bateman TM, Cerqueira MD, Iskandrian AE, Leppo JA, Blackburn B, Mahmarian JJ (2005) Initial clinical experience with regadenoson, a novel selective A2A agonist for pharmacologic stress single-photon emission computed tomography myocardial perfusion imaging. J Am Coll Cardiol 46(11):2069–2075

    Article  PubMed  CAS  Google Scholar 

  11. Huber CH, Tozzi P, Corno AF, Marty B, Ruchat P, Gersbach P, Nasratulla M, von Segesser LK (2004) Do valved stents compromise coronary flow? Eur J Cardiothorac Surg 25(5):754–759

    Article  PubMed  Google Scholar 

  12. Jatene MB, Monteiro R, Guimaraes MH, Veronezi SC, Koike MK, Jatene FB, Jatene AD (1999) Aortic valve assessment. Anatomical study of 100 healthy human hearts. Arq Bras Cardiol 73(1):75–86

    Article  PubMed  CAS  Google Scholar 

  13. Leschka S, Scheffel H, Desbiolles L, Plass A, Gaemperli O, Valenta I, Husmann L, Flohr TG, Genoni M, Marincek B, Kaufmann PA, Alkadhi H (2007) Image quality and reconstruction intervals of dual-source CT coronary angiography: recommendations for ECG-pulsing windowing. Invest Radiol 42(8):543–549

    Article  PubMed  Google Scholar 

  14. Lutter G, Ardehali R, Cremer J, Bonhoeffer P (2004) Percutaneous valve replacement: current state and future prospects. Ann Thorac Surg 78(6):2199–2206

    Article  PubMed  Google Scholar 

  15. Muriago M, Sheppard MN, Ho SY, Anderson RH (1997) Location of the coronary arterial orifices in the normal heart. Clin Anat 10(5):297–302

    Article  PubMed  CAS  Google Scholar 

  16. Scheffel H, Alkadhi H, Plass A, Vachenauer R, Desbiolles L, Gaemperli O, Schepis T, Frauenfelder T, Schertler T, Husmann L, Grunenfelder J, Genoni M, Kaufmann PA, Marincek B, Leschka S (2006) Accuracy of dual-source CT coronary angiography: First experience in a high pre-test probability population without heart rate control. Eur Radiol 16(12):2739–2747

    Article  PubMed  Google Scholar 

  17. Stolzmann P, Scheffel H, Schertler T, Frauenfelder T, Leschka S, Husmann L, Flohr TG, Marincek B, Kaufmann PA, Alkadhi H (2007) Radiation dose estimates in dual-source computed tomography coronary angiography. Eur Radiol 18:592–599

    Article  PubMed  Google Scholar 

  18. Stolzmann P, Scheffel H, Schertler T, Frauenfelder T, Leschka S, Husmann L, Flohr TG, Marincek B, Kaufmann PA, Alkadhi H (2008) Radiation dose estimates in dual-source computed tomography coronary angiography. Eur Radiol 18(3):592–599

    Article  PubMed  Google Scholar 

  19. Swanson M, Clark RE (1974) Dimensions and geometric relationships of the human aortic valve as a function of pressure. Circ Res 35(6):871–882

    PubMed  CAS  Google Scholar 

  20. Thubrikar M (1990) The aoric valve. CRC Press, Inc, Boca Raton, Florida, USA

    Google Scholar 

  21. Turner K, Navaratnam V (1996) The positions of coronary arterial ostia. Clin Anat 9(6):376–380

    Article  PubMed  CAS  Google Scholar 

  22. Vlodver Z, Vlodaver Neufeld HN, Edward JE (1975) Coronary arterial variations in the normal heart and in congential heart disease. Academic Press Inc, New York

    Google Scholar 

Download references

Acknowledgments

This paper was supported by the National Center of Competence in Research for Computer Aided and Image Guided Medical Interventions (NCCR CO-ME) of the Swiss National Science Foundation.

Author information

Authors and Affiliations

  1. Laboratory of Thermodynamics in Emerging Technologies, Department of Mechanical and Process Engineering, ETH Zurich, Sonneggstrasse 3, ML J 36, 8092, Zurich, Switzerland

    Joseph Knight, Vartan Kurtcuoglu & Dimos Poulikakos

  2. College of Medicine, University of South Florida, Tampa, FL, USA

    Karl Muffly & William Marshall Jr

  3. Biostatistics Unit, ISPM, University of Zurich, Zurich, Switzerland

    Paul Stolzmann, Lotus Desbiolles & Hatem Alkadhi

  4. Institute of Diagnostic Radiology, University Hospital Zurich, Zurich, Switzerland

    Burkhardt Seifert

Authors
  1. Joseph Knight
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vartan Kurtcuoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karl Muffly
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William Marshall Jr
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Paul Stolzmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Lotus Desbiolles
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Burkhardt Seifert
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Dimos Poulikakos
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Hatem Alkadhi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dimos Poulikakos.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Knight, J., Kurtcuoglu, V., Muffly, K. et al. Ex vivo and in vivo coronary ostial locations in humans. Surg Radiol Anat 31, 597–604 (2009). https://doi.org/10.1007/s00276-009-0488-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00276-009-0488-9

Keywords

Search

Navigation