Abstract
Introduction: The year 1928 saw the first human coronary angiograph when Werner Forssmann inserted a ureteral catheter into his left anticubital vein and advanced it to the heart. Today coronary angiographies and selective coronary angiographies are being done quite frequently. Presence of supernumerary ostia can make it difficult to correctly interpret angiographic films. Also during selective angiography such ostia are difficult to cannulate. The knowledge of position of coronary ostia with respect to aortic sinuses and possible variations in their locations will aid in carrying out these procedures as well as in interpreting them.High position of ostia in comparison to the aortic sinuses has been found to be related to poor filling of coronary arteries during diastole. The knowledge of position of ostia, could help in correct interpretation of patient's symptoms and could help in channalizing the further line of treatment.Aim: To study the variations in the number and position of coronary ostia in relation with aortic sinuses.Materials and Methods: A total of 50 human hearts were included in this study irrespective of sex. The hearts were procured from dissection room adult cadavers of Dr D Y Patil Medical College, Pune and were preserved in 10% formalin.The origins of both the coronary arteries were noted while looking out for presence of any extra ostia in either of the three aortic sinuses. Depending on whether the ostia were situated below, at or above the cuspal margin they were classified as those taking origin from the sinus, sinuaortic junction or ascending aorta.Results: In this study the ostium for right coronary artery was located in the anterior aortic sinus in 98% cases and in right posterior aortic sinus in 2% cases. The ostium for left coronary artery was located in the left posterior aortic sinus in 100% cases. The maximum height of ostium from the sinuaortic junction in case of coronary arteries taking origin directly from aorta was found to be 1.5mm.Regarding study of number of ostia found in the aortic sinuses-22% hearts showed presence of 2 ostia, 2% hearts showed 3 separate ostia and 2% hearts showed 5 ostia in the anterior aortic sinus region. No supernumerary ostia were found in the left posterior aortic sinus region. 2% incidence of circumflex artery taking origin from the anterior aortic sinus was observed.
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