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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.
Case ExamplesEducational Content

ATHERECTOMY COMPLICATIONS

Case ExamplesEducational Content

BYPASS GRAFT COMPLICATIONS