A Cross-sectional Study of Anatomical Variations of Coronary Ostia in the Adult Human Hearts and its Clinical Significance

Abstract

Introduction: The knowledge of anatomical variations of the coronary ostia is an important factor in the study of Coronary Heart Disease (CHD). With the adaptation of sedentary life style and increasing stress, CHD has become the major cause of death in many countries. Aim: To describe the location, size and shape of the coronary ostia in cadaveric hearts. Materials and Methods: Descriptive cross-sectional study was carried out in 110 adult human hearts, 90 males and 20 females with a mean age of 66 years, which were collected from the mortuary from March 2017 to March 2019. The aorta was dissected and the aortic sinuses were opened, the number, location, size, shape and anomalous presence of accessory coronary ostia was noted and the measurements were taken using vernier calipers. Results: The Right Coronary Artery (RCA) was seen taking origin from the anterior aortic sinus and the Left Coronary Artery (LCA) from the left posterior aortic sinus in all the 110 hearts. The mean diameter of the Left Coronary Ostia (LCO) was 3.66±0.40 mm and found to be greater than the Right Coronary Ostia (RCO) 3.43±0.38 mm. Variations in the location and shape of the RCO and LCO were noted, and presence of single accessory coronary ostia was observed in five cases. Presence of multiple accessory coronary ostia was observed in only one case and its presence was found to be very rare. Conclusion: The diameter of the LCO was found to be greater than the RCO and the shape was circular in most of the coronary ostia. The majority of the coronary ostia were found to be located within the aortic sinuses below the Sinutubular Junction (STJ). Anatomical knowledge of the coronary ostia in the ascending aorta is very important during cardiac interventions around the aortic root.