Anatomical considerations regarding the coronary arterial ostia

Abstract

Introduction Coronary artery disease remains one of the most prevalent cardiovascular disorders worldwide and continues to represent the leading cause of morbidity and mortality. Its incidence varies between 15 and 200 per 100,000 individuals, with an overall prevalence of approximately 2.5% in the general population. The burden increases substantially with age and sex, affecting up to 15% of men between 50 and 70 years. Detailed knowledge of coronary artery anatomy, including the morphology of the coronary ostia, is essential for both diagnostic assessment and surgical or interventional procedures. Material and methods The present study evaluated the morphological characteristics of the coronary ostia in 288 cases. Particular attention was given to the topographic position relative to the aortic valve margin, as well as to the shape and dimensions of the ostia. The left coronary ostium was situated above the valvular margin in 68% of cases, whereas the right coronary ostium presented this location in 56% of cases. Results In terms of morphology, the left coronary ostium was most frequently oval (72%), with the larger diameter ranging between 4.8–7.6 mm and the smaller diameter between 4.6–6.3 mm. The right coronary ostium also exhibited a predominance of the oval shape (78%), with the larger diameter measuring 3.1–4.4 mm and the smaller diameter 2.5–3.3 mm. An anatomical variation consisting of three coronary ostia was identified in 8 cases (2.78%). Conclusion A thorough understanding of the location, shape, and dimensions of the coronary ostia is crucial for optimizing surgical planning and improving outcomes in coronary revascularization procedures. These anatomical parameters directly influence graft selection and surgical strategy, thereby contributing to the long-term success of CABG.