International Journal of Anatomy and Research

Welcome to International Journal of Anatomy and Research




Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 1 | Page No. 1905-1911

Date of Publication: 29-02-2016



Hima Bindu Nalluri *1, Abid Ali Mohammed 2, Vasntha Leela 3.

*1 Associate Professor of Anatomy, Bhaskar Medical College, Hyderabad, Telangana, India.
2 Assistant Professor of Anatomy, Bhaskar Medical College, Hyderabad, Telangana, India.
3 Professor of Anatomy, Deccan College Of Medical Sciences, Hyderabad, Telangana, India.

Address: Dr. Hima Bindu Nalluri, Associate Professor of Anatomy, Bhaskar Medical College, Yenkapally, Moinabad, Ranga Reddy, Hyderabad, Telangana 500075, India.


Introduction: In the light of increased incidence of coronary arterial diseases, knowledge of the variations in the number and location of coronary ostia is essential in the planning of various interventional and surgical procedures on the coronary arteries as well as aortic valve replacements.
Aim: To investigate the variations in the origin, number, size and location of coronary ostia in relation to aortic leaflets.
Methods: Eighty adult human cadaveric hearts with great vessels in situ were studied for coronary ostia.
Results: 78 hearts had tricuspid aortic valve and two hearts had bicuspid aortic valve. Anomalous origins of right coronary artery from the left posterior aortic sinus in one heart and the left coronary artery from the non-coronary sinus in another heart were noted. Both right and left coronary arteries arose from the anterior aortic sinus in two hearts with bicuspid aortic valve. Single right coronary ostium was seen in 63 hearts (78.75%), two right coronary ostia were found in 14 hearts (17.5%), three right coronary ostia were found in two hearts (2.5%), and four were found in one heart(1.25%). The left coronary ostium was single in all hearts. The mean diameter of right coronary ostium (RCO) was 3.17±0.87 mm and of the left coronary ostium (LCO) was 4.1±0.83 mm. The relation of the right and left coronary ostia to the sinu-tubular junction, to the bottom of the related sinus and to the commissures was also analyzed in detail.
Conclusion: This study provides data on normal coronary ostial morphometry and topography and there were significant differences in the number of right coronary ostia than of the left coronary ostium. The observed large variations of coronary ostial position in relation to the sinu-tubular junction and to the bottom of the aortic sinus emphasize the importance of considering such anatomic variations in the development of treatments for coronary artery occlusion.
Key words: Coronary Ostia, Sinu-Tubular Junction, Aortic Sinuses, Right Coronary Ostium, Left Coronary Ostium.


  1. Standring S, Ellis H. Healy J C, Jhonson D, Williams A, Collins P, et al. Heart and Great vessels. In: Gray’s Anatomy – The Anatomical Basis of Clinical Practice. 36th Ed, London: Churchill Livingstone: 2005 p. 1008 – 17.
  2. Steinberger J, Lucas RV Jr, Edwards JE, Titus JL, Causes of sudden unexpected cardiac death in the first two decades of life. Am J Cardiol. 1996;77:992-5.
  3. Basso C, Maron BJ, Corrado D, Thiene G, Clinical profile of congenital coronary anomalies with origin from the wrong aortic sinus leading to sudden death in young competitive athletes. J Am Coll Cardiol. 2000;35:1493-501.
  4. Angeline P. Coronary artery anomalies: an entity in search of an identity. Circulation, 2007:115:1296-305.
  5. Ottaviani G, Lavezzi AM, Matturi L. Sudden unexpected death in young athletes. Am J Forensic Med Pathol. 2008;29:337-9.
  6. Lutter G, Ardehali R, Cremer J, Bonhhoeffer P  Percutaneous valve replacement: current state and future prospects. Ann Thorac Surg, 2004: 78(6): 2199-2206
  7. Babaliaros V, Block P. State of the art percutaneous intervention for the treatment of valvular heart disease: a review of the current technologies and ongoing research in the field of percutaneous valve replacement and repair.2007: Cardiology 107(2):87-96.
  8. Boudjemline Y, Bonhoeffer P. Steps toward percutaneous aortic valve replacement. Circulation, 2002: 105(6):775-778.
  9. Roberts WC. Anatomically isolated aortic valvular disease: the case against its being of rheumatic etiology. Am J Med. 1970;49:151–159.
  10. Larson EW, Edwards WD. Risk factors for aortic dissection: a necropsy study of 161 cases. Am J Cardiol. 1984;53:849 – 855.
  11. Gray GW, Salisbury DA, Gulino AM. Echocardiographic and color flow Doppler findings in military pilot applicants. Aviat Space Environ Med. 1995;66:32–34.
  12. Schang SJ, Pepine CJ, Bemiller CR. Anomalous coronary artery origin and bicuspid aortic valve. Vasc Surg 1975;9:67-72.
  13. Gershoni-Baruch R, Moor EV, Enat R. Marfan syndrome associated with bicuspid aortic valve, premature aging, and primary hypogonadism. Am J Med Genet 1990;37:169-172.
  14. Kimbivis D, Iskandrian AS, Segal BL, Beuis CE. Anomalous aortic origin of coronary arteries. Circulation 1978; 58: 606-615.
  15. Davis JA, Cecchin F, Jones TK, Portman MA; Major coronary artery anomalies in a paediatric population: Incidence and clinical importance. J Am Coll Cardiol 2001; 37:593-597
  16. Catanzaro JN, Mararyus AN, Catanese C; Sudden cardiac death associated with an extremely rare coronary anomaly of the left and right coronary arteries arising exclusively from the posterior (non-coronary) sinus of Valsalva. Clin Cardio. 2005; 28: 542-544
  17. Palimar V, Pamidi N, Rakul V, Vollala VR, Kumar S, Jetti R. Origin of right coronary artery from left sinus of Valsalva. International Journal of Anatomic Variations .2001; 1:12-13.
  18. D’souza MR, Raj B, Saxena A, Rastogi P, D’Souza AS, Gupta C et al. Variations of origin of coronary artery and their importance. J Morphol.Sci., 2015; 32,1: 1-7
  19. Parimal S, Srilatha. Measurements and location of coronary ostia. Int. J. Biol. Med. Res. 2012;3(4):2489-2496.
  20. Lo PH, Chang KC, Hung JS, Chen HL, Fanx CY, Fu M, Wu CJ, Lau KW. Anomalous origin of left main coronary artery from the non-coronary sinus: An intravascular ultrasound observation. Cathet Cardiovasc Diagn. 1997; 42(4):430-433.
  21. Taylor AJ, Rogan KM, Virmani R. Sudden cardiac death associated with isolated congenital coronary artery anomalies. J Am Coll Cardiol 1992; 20:640-647
  22. Barth CW 3rd, Roberts WC. Left main coronary artery originating from right sinus of Valsalva and coursing between the aorta and pulmonary trunk. J Am Coll Cardiol 1986; 7:366-373
  23. Schlesinger MJ, Zoll PM, Wessler S. The conus artery: a third coronary artery. Am Heart J. 1949; 38:823-36
  24. James TN. Anatomy of coronary arteries. Circulation 1965; 32:1020-33
  25. Wolloscheck T, Zipfel J, Konerding MA. Aortic valve structures as landmarks for determining coronary artery ostia in transthoracic echocardiography Herz. 2001; 26:461-7
  26. Gosva F, Celik S, Aktas EO, Aktas S, Kocak A, Boydak B, Sen F. Anatomic variability of the coronary artery orifices. Anadolu Kardiyol Derg 2010;10:3-8
  27. Cavalcanti JS, de Melo NC, de Vasconcelos RS. Morphometric and topographic study of coronary ostia. Arq Bras Cardiol 2003;81(4):359-362
  28. Kohler F, Bless H and Pittner PM. Post mortem radiological studies of human coronary ostia. Rofo. 1981; 134(5):476-482
  29. Bhimali S, Dixit D, Siddibhavi M, Shirol VS. A study of variations in coronary arterial system in cadaveric human hearts. WJST. 2011;1(5):30-35
  30. Muriago M, Sheppard MN, Ho SY, Anderson RH. Location of the coronary arterial orifices in the normal heart. Clin Anat 1997; 10:297-302.
  31. Nishi H, Mitsuno M, Tanaka H, Rymoto M, Fukui S, Miyamoto Y. High anomalous origin the right coronary artery associated with aortic stenosis: a word of caution. Ann Thorac Surg. 2010 Mar;89(3):961-3.
  32. Joshi SD, Joshi SS, Athavale SA, Origins of the coronary arteries and their significance. Clinics. 2010;65:79-84.
  33. Turner K, Navratnam V. The position of coronary arterial ostia. Clin Anat. 1996; 9:376-80.
  34. Jatene MB, Monteiro R, Guimaraes MH, Veronezi SC, Koike MK, Jatene FB, et al. Aortic valve assessment. Anatomical study of 100 healthy human hearts. Arq Bras Cardiol 1999;73:75-86.


Hima Bindu Nalluri, Abid Ali Mohammed, Vasntha Leela. ANATOMIC VARIABILITY OF CORONARY OSTIA IN ADULT HUMAN CADAVERIC HEARTS. Int J Anat Res 2016;4(1):1905-1911. DOI: 10.16965/ijar.2016.110




Volume 1 (2013)

Volume 2 (2014)

Volume 3 (2015)

Volume 4 (2016)

Submit Manuscript