冠状动脉的起源与意义

目的 观察中国人冠状动脉开口的变异情况，为临床冠状血管造影和介入术提供解剖学参考。 方法 选择 55例保存完好的心脏标本，探查每例标本的主动脉窦，观察各个窦中冠状动脉开口的数目和位置，测量从窦底分别到瓣尖、冠状动脉开口以及窦管交界的高度，并对所得结果进行记录和分析。 结果 主动脉窦中冠状动脉开口总数为2～5个不等，多数情况下右冠状动脉开口于主动脉右窦，回旋支和左冠状动脉合并开口于主动脉左窦，肺动脉窦或主动脉后窦中未发现开口。大多数开口位于窦管交界以下（94.5%）和瓣尖上缘以上（80%），5例标本存在高位开口，即开口位置高于窦管交界。 结论 多数冠状动脉开口的位置在主动脉右窦和主动脉左窦内，瓣尖之上，窦管交界之下。一些变异比如多开口、纵向或环向的位置偏移及裂隙状开口会对解释图像带来困难，对临床进行血管造影、血管成形术、冠状动脉旁路移植术等操作造成不利影响。

Origin and significance of coronary artery

Objective To describe the normal and variant anatomy of the coronary artery ostia in Chinese subjects, and to provide data reference for coronary angiography and intervention. Methods Fifty-five heart specimens were dissected. The number of ostia and their positions within the respective sinuses were observed. Vertical and circumferential deviations of the ostia were observed. The heights of the cusps, the ostia and sinutubular ridge from the bottom of aortic sinus were measured and recorded, analyzed and reported the result . Results The number of openings in the aortic sinuses varied from 2-5 in the present series; multiple ostia were mostly seen in the anterior sinus. The majority of the ostia was below the sinutubular ridge (94.5%) and at or above the level of the cusps (80%). No openings were present in the pulmonary sinuses and posterior aortic sinus. There were high openings in 5 specimens, which were higher than the sinutubular junction. Conclusion Most of the coronary openings are located in the right aortic sinus or left aortic sinus, above the cusps and below sinutubular ridge. Some mutations, such as multiple openings, longitudinal or circumferential positional shifts, and slit-like openings can cause difficulties in interpreting images, and adversely affect clinical operations such as angiography, angioplasty and coronary artery bypass grafting.