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Abstract
Background: The 3D configuration of the aortic‐coronary junction is decisive in stenting ostial coronary lesions. We hypothesized that it varies between straight to funnel–shaped tubes and studied arterial orifices using computerized tomographic coronary angiography (CTCA). Methods and Results: Axial and sagittal 2‐D and volumetric 3‐D reconstructions of the aorto‐coronary junction were performed in 25 patients who underwent CTCA. The following measurements of the left main (LM) and right coronary (RCA) arteries ostia were obtained: the coronary orifice broad base diameter, the diameter of the coronary vessel most proximal segment, the distance between them, and the angles of the aortic‐coronary junction. All patients exhibited a funnel–shaped aortic‐coronary junction in at least one plane, and none had an entirely straight tube shape. The RCA take–off had symmetric angling in both the axial and sagittal planes in only one patient, while the LM did not have a symmetric origin in either plane in any patient. The mean coronary orificial funnel depth and ostial cross–sectional diameters were measured. Conclusion: The frequency of funnel‐shaped and asymmetry of the aortic‐coronary junction configuration needs to be considered in designing stents for aortic–ostial coronary lesions in order to achieve optimal results and reduce restenosis.