Applied Anatomy: Height of Coronary Ostia
- A high implantation of a self-expanding valve coupled with low lying coronary ostia would make coronary re-access more difficult.
- If coronary ostia height is lower than valve skirt height (B), selective coronary engagement cannot be done co-axially from a diamond in front of the opening. Instead engagement will occur from a diamond above the ostium with a straighter catheter with a short-tip such as a JR4 (Tool-box).
- A high implantation of a balloon-expandable valve coupled with low lying coronary ostia can make coronary re-access more difficult.
- If coronary access height is lower than valve skirt height, selective coronary engagement cannot be done co-axially from a diamond in front of the opening. Instead engagement will occur from a diamond above the ostium, and a straighter catheter with a short tip such as a JR4 could be used even for the left main engagement.
