The positions of coronary arterial ostia

Turner, Kevin; Navaratnam, V.

doi:10.1002/(sici)1098-2353(1996)9:6<376::aid-ca3>3.0.co;2-9

Cited by 38 publications

(40 citation statements)

References 8 publications

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“…16,25,26 It is not unusual, however, for the arteries to be positioned superior relative to the sinutubular junction. In a study of 51 normal postmortem hearts, the mean distance measured from the orifice of the left coronary artery to the basal attachment of the corresponding leaflet was 12.6Ϯ2.61 mm, and for the right coronary artery it was 13.2Ϯ2.64 mm.…”

Section: Location Of the Coronary Arteriesmentioning

confidence: 99%

Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve

Piazza¹,

Jaegere²,

Schultz³

et al. 2008

Circ: Cardiovascular Interventions

553

320

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Abstract-The books and articles devoted to the anatomy of the aortic valvar complex are numerous. Until now, however, little consideration has been given to understanding the anatomy with percutaneous valvar replacement in mind. It is axiomatic that knowledge of the anatomy of the valve is fundamental in understanding key principles involved in valvar replacement. Such an appreciation of the anatomy helps better understand the optimal positioning for the prosthetic valve within the root of the aorta with respect to the coronary arteries, mitral valve, and the conduction system and may circumvent complications that can arise during its implantation. In this review, therefore, we describe the anatomy of the trifoliate aortic valvar complex and its implications for percutaneous valvar replacement. Key Words: anatomy Ⅲ aorta Ⅲ catheters Ⅲ stenosis Ⅲ valves T he realization that it is now possible to replace the aortic valve percutaneously has created awareness among cardiologists of the importance in the anatomy of the aortic valvar complex. The earliest documented interest in the anatomy of the aortic valvar complex stems from the Renaissance, with the description and drawings by Leonardo da Vinci (1513). The books and articles devoted to this topic are numerous. [1][2][3][4] . Until now, however, little consideration has been given to understanding the anatomy with percutaneous valvar replacement in mind. There are a number of designs for valves that can be inserted percutaneously in aortic position, but thus far most experience has been gained using the Edwards SAPIEN prosthetic heart valve or the CoreValve ReValving System. [5][6][7] Implantation is achieved by either a transfemoral or transapical approach. Generally speaking, the prosthesis is positioned within the aortic root and, once deployed, crushes the leaflets of the native valve against the wall. It is axiomatic that knowledge of the anatomy of the valve is fundamental in understanding key principles involved in valvar replacement. Such an appreciation of the anatomy helps better to understand the optimal positioning for the prosthetic valve within the aortic root with respect to the coronary arteries, mitral valve, and the conduction system, and may circumvent complications that can arise during its implantation. In addition, the need for accurate knowledge of the aortic valvar complex is imperative, not only as percutaneous therapies of the aortic valve become clinically established but also in the new design and refinements of current valvar technology. In this review, therefore, we describe the anatomy of the trifoliate aortic valvar complex and its implications for percutaneous valvar replacement. The presence of an aortic valve with 2 leaflets is currently considered a contraindication to transcatheter implantation of the aortic valve. This topic, therefore, although of unequivocal importance, has been omitted, in the interest of brevity, from our discussion of the anatomy of the aortic valvar complex. Description of the Type of Transcatheter Aor...

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Section: Location Of the Coronary Arteriesmentioning

confidence: 99%

Anatomy of the Aortic Valvar Complex and Its Implications for Transcatheter Implantation of the Aortic Valve

Piazza¹,

Jaegere²,

Schultz³

et al. 2008

Circ: Cardiovascular Interventions

553

320

View full text Add to dashboard Cite

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“…Though some studies [6,12,15,21,22] have been performed to determine ostial locations (Table 1), each of these studies was limited in that the measurements were taken from cadavers. Further, challenges associated with determining the exact location of the reference points for making such measurements can be seen in the fact that each previous study uses a diVerent method of measurement.…”

Section: Introductionmentioning

confidence: 99%

“…Given the varied methods of measurements of the ostial location of previous ex vivo studies [6,12,15,21,22], we also took measurements of the ostial locations in a sample of cadavers to determine the variance of ex vivo measurements to those taken in vivo. We sought to identify to what extent the in vivo measurements of the coronary ostial locations diVer from those made in cadavers.…”

Section: Introductionmentioning

confidence: 99%

Ex vivo and in vivo coronary ostial locations in humans

et al. 2009

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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. Conclusions This study provides data of normal coronary ostial origins and demonstrates signiWcant diVerences 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. Results

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“…Muriago et al, and Turner and Navaratnam also reported similar findings in autopsy studies. 14, 15 The right coronary artery is anatomically designed to pass around the tricuspid valve; therefore, it is appropriate for its orifice to be located on the N-R commissural side. Hence, this bias may be an appropriate finding.…”

Section: Resultsmentioning

confidence: 99%