Calcified aortic sinotubular ridge: a source of coronary ostial stenosis or embolism

This report reviews the findings in a calcified lesion involving the ridge at the junction of the sinus and tubular portions of the ascending aorta. The histologic features resemble the alterations in calcified aortic valve and do not exhibit those of atherosclerosis. The 37 cataloged cases are among the more severe and dramatic instances of a lesion more common than the cataloged number would suggest. The involved ridge may be related to any of the sinuses, although that related to the right aortic sinus is most commonly affected. Major complications include coronary ostial stenosis or embolism in an epicardial coronary artery. Ostial stenosis results either from overhanging of an ostium by the aortic lesion or from invasion of the wall of the aorta at the site of the arterial takeoff.