Anatomic variability of the coronary arterial orifices

Anatomical differences in coronary orifices (CO) are important as they are associated with myocardial ischemia and sudden death. The location of coronary orifices to the aortic valve has been studied since it is a determining point in surgical and radiological attempts.

The number, position, and shape of the CO, and their relation to the sinotubular junction (SJ), were studied in 100 normal adult hearts. Student-t test, one- and two-way ANOVA with posthoc Tukey's HSD tests were applied for statistical analysis.

The mean height of the right, non- and left coronary sinuses were 18.75+/- 1.71, 17.86+/- 1.55 and 16.41+/- 1.21 mm, respectively. The mean height of the right, non- and left coronary cusps were measured as 16.2+/- 1.2, 15.9+/- 1.1 and 12.3+/- 2.1 mm, respectively. The left coronary artery (LCA) was observed to arise from the lower part of the SJ in 58% of the patients, while in 29% of them it originated from the SJ, and in 13% of the cases it arose from the upper part of the SJ. The right coronary artery (RCA) arising from the lower part of the SJ was seen in 78% of the patients, while it originated from the SJ in 13% of the patients, and it was observed to arise from the upper part of the SJ in 9 specimens. The diameters of the LCA and RCA were measured as 4.22+/- 0.72 and 3.32+/- 0.82 mm, respectively. An accessory orifice was found on the left in 47 specimens, while it was seen on the right in 54 of them.

The location of the CO should be identified according to the vertical and horizontal surfaces of the sinus. In this study, the frequency of the coronary artery orifices with different locations was provided. Such data will increase the success of coronary interventions and decrease complication rate.