Aortic Root anatomy is the basic mantra of Cardiac Surgery. Without thorough knowledge on this, a surgeon cannot work in the delicate area of heart.
There are three sinus of the aortic valve- Left Coronary Sinus, Right Coronary Sinus and Non coronary Sinus. The Non Coronary Sinus is also known as the Posterior Coronary sinus because of its location. Each sinus has three areas- a central part and two adjacent areas named according the valve cusps they adjoin.
Right Coronary Sinus: It lies adjacent to the RVOT. The central part lies adjacent to the Crista Supraventricularis. Left part is in the angle between the crista supraventricularis and the pulmonary valve. The posterior part is posterioroinferior to the crista supraventricularis. Left part is related to the muscular part of the inter ventricular septum where as the central and the inferior part is related to either the muscular or the membranous part of inter ventricular septum.
Non Coronary Sinus: The right and central part of the non coronary sinus are related to the right atrium and the interatrial septum. The left part is related to left atrium. Inferiorly, the right part related to the membranous or the muscular septum. Beneath the central part the membranous septum is always present. The left part inserts into the anterior mitral leaflet.
Left Coronary Sinus: Posterior part is related to the left atrium posteriorly and to the anterior mitral leaflet inferiorly. Central part of the left coronary sinus is the only part of the aortic root that is not related to a cardiac chamber, it is adjacent to the epicardium only. The right part lies adjacent to the pulmonary trunk and inferior to it lies the muscular inter ventricular septum.
A concrete knowledge on the aortic root anatomy can help the surgeon for aortic root enlagement procedure or during the closure of the ventricular septum in TOF and carefulness for the complications it can lead to.