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Computed tomography angiographic examination of coronary sinus morphometry and spatial orientation: a guide for
Tayfun Aygün1, Serkan Arıbal2, Mustafa Ahmet Huyut3
1Department of Anatomy, Faculty of Medicine, Giresun University, Giresun, Turkiye. fzttayfunaygun@gmail.com.
Insights
Coronary sinus ostium (CSO) dimensions vary with age and sex, with spatial orientation being sex-independent. Preoperative imaging aids planning for cardiac interventions.
Area of Science:
- Cardiovascular Imaging
- Cardiac Anatomy
- Interventional Cardiology
Background:
- Understanding coronary sinus ostium (CSO) anatomy is crucial for cardiac interventions.
- Computed tomography angiography (CTA) offers detailed 3D visualization of cardiac structures.
Purpose of the Study:
- To characterize CSO morphometrics and 3D spatial orientation.
- To identify demographic and anatomical determinants of CSO level.
Main Methods:
- Retrospective analysis of 300 individuals undergoing coronary CTA.
- Measurement of CSO and coronary sinus dimensions, CSO level, wall thickness, and coronary artery diameters.
- Assessment of CSO spatial angles in axial, coronal, and sagittal planes.
Main Results:
- CSO and coronary sinus diameters increased with age; CSO level decreased with age.
- Male sex was associated with higher CSO level; older age, greater septal thickness, larger CSO diameter, and larger sagittal angle with lower CSO level.
- CSO spatial orientation showed no significant sex differences.
Conclusions:
- CSO morphometrics show sex-related differences, but 3D spatial orientation is sex-independent.
- Age influences CSO dimensions and level.
- Preoperative CTA enhances understanding of CSO anatomy for procedural planning.
Background:
This study aimed to characterize the morphometric features and three-dimensional spatial orientation of the coronary sinus ostium (CSO) within the right atrium using computed tomography angiography, and to identify demographic and anatomical determinants of CSO level.
Materials And Methods:
A total of 300 individuals (147 women and 153 men; mean age, 50.27 ± 10.39 years) who underwent coronary computed tomography angiography (CTA) were included in this retrospective cross-sectional study. Morphometric parameters included the proximal and distal coronary sinus diameters, CSO diameter, CSO-right atrial floor distance (CSO level), mean left ventricular wall thickness, septal wall thickness, proximal diameters of four major coronary arteries, and axial, coronal, and sagittal spatial angles of the CSO.
Results:
All coronary artery diameters and both ventricular wall-thickness measures were significantly greater in men. Coronary sinus and CSO diameters increased with age, whereas CSO level decreased (r = -0.221, p < 0.001). The CSO formed angles of 65.15° ± 11.08°, 33.51° ± 17.95°, and 32.58° ± 17.47° with the axial, coronal, and sagittal planes, respectively, with no significant sex differences. In multivariable logistic regression analysis, male sex was independently associated with a higher CSO level, whereas older age, greater septal wall thickness, larger CSO diameter, and a larger sagittal angle were associated with a lower CSO level; mean left ventricular (LV) free-wall thickness (anterior and lateral) was not an independent predictor.
Conclusions:
Selected coronary sinus and cardiac morphometric parameters exhibited sex-related differences, while coronary sinus and CSO diameters increased progressively with age. The three-dimensional spatial orientation of the CSO within the right atrium appears to be a sex-independent anatomical parameter.Preoperative CTA may contribute to a better understanding of coronary sinus anatomy and, in selected cases, may facilitate procedural planning for coronary sinus-based cardiac interventions.
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