Anatomy of the aortic root and the coronary ostia: Ct evaluation

Abstract

Introduction: As there is a growing number of percutaneous interventions, scrupulous attention and profound knowledge of the aortic root and neighboring structures is required. The objective of the study is to describe the anatomy of the aortic root and the coronary ostia in asymptomatic patients using CT. Methods: Eighty-five patients without any clinical symptoms suggestive of the aortic root and coronary arteries diseases underwent contrast-enhanced MDCT. CT angiography was performed with a 64-row helical CT scanner after administration of the non-ionic, iodinated contrast agent. Results: CT angiography depicted the entire structure of the aortic root. The aortic root encompasses several distinct elements, namely the aortic annulus, the aortic valve leaflets and their (leaflet) attachments, the interleaflet triangles, the sinuses of Valsalva, the coronary arteries ostia and the sinotubular junction. CT angiography depicted the distance between the aortic annulus and the margins of the left and right coronary ostia. While carrying out the analysis, the precise description of the anatomy of the sinotubular junction and the valve leaflet attachments has to be made. Sinuses of Valsalva normally consist of the right, left and posterior cusps. Left and right coronary ostia are located below the upper margin of the cusps. Conclusion: When analyzing the anatomy of the aortic root and the coronary ostia, each entity should be examined separately. It is important to take into account the relationship between the structures the aortic root encompasses. Changes in the size of one structure cause the improper functioning of the adjacent ones.