A cadaveric study on the anatomical variations of origin of the coronary arteries in Gujarat state

Abstract

INTRODUCTIONThe coronary arteries arise from the aortic sinuses. The initial portion of the aortic root, which houses the leaflets of the aortic valve, is occupied by the aortic sinuses, also called the sinuses of Valsalva.[1] The aortic sinuses reach beyond the upper border of the cusp and form a well-defined, complete, and circumferential sinutubular ridge when viewed from the aortic aspect. These sinuses are named according to their position as the anterior, left posterior, and right posterior aortic sinuses. The right coronary artery (RCA) arises from the anterior coronary sinus and the left coronary artery (LCA) from the left posterior aortic sinus. In clinical terminology, the anterior, left and right posterior sinuses are often called the right, left, and non-coronary sinuses, respectively. Recently, coronary artery anomalies as a cause of coronary heart disease are gaining consideration in the diagnostic workup. One of the subsets of coronary artery anomalies is the anomalous origin. This subgroup has important clinical manifestations, including sudden death, especially in young athletes. The recent introduction of selective coronary arteriography that provides an accurate localization of the anatomical variations and underlying pathology, the advances made in coronary arterial bypass graft surgeries and modern methods of myocardial Background: A thorough knowledge of the anatomy of coronary arteries, the crown of the heart does a self-evident prerequisite for more intelligent planning of surgery or a complete understand of the coronary artery disease. Abnormal origin of coronary arteries may cause potentially dangerous symptoms and even sudden death during strenuous activity. A cadaveric study in an unsuspected population provides a basis for acknowledgment of normal variants, which may facilitate determination of prevalence and evaluation of the value of screening for such anomalies. Objectives: This study was conducted with an aim to describe the anatomical variation in the origin of right and left coronary arteries (RCA and LCA). Materials and Methods: This study based on the examination of 100 cadaveric hearts from the anatomy dissection room and obtained at an autopsy department. By using conventional dissecting techniques, heart specimens were dissected and studied for number of ostia, and their position within respective sinuses. The heights of the ostia from the bottom of sinuses were measured with the help of Vernier caliper. Results: There was no opening found in pulmonary artery and non-coronary sinus coronary arteries. Single, double and triple ostia were present in 78%, 20%, 2% of cases, respectively. The height of coronary ostia from the bottom of the respective aortic cusp which was measured by digital Vernier caliper depicts that RCA ostium was higher than that of the LCA ostium. Conclusion: The findings in this study may provide a basis for understanding the normal variants, for determining the incidence of anomalies, and for evaluating the value of screening for such anomalies.