Aortic sinus

*Aortic sinus*
Aortic sinus
	Aorta laid open to show the semilunar valves. (N.B. captions don't align with current terminology)
Details
Synonyms	sinus of Valsalva
Identifiers
Latin	sinus aortae
MeSH	D012850
TA98	A12.2.03.002
TA2	4001
FMA	3745
	Anatomical terminology [ edit on Wikidata]

Last updated April 19, 2021

An aortic sinus, also known as a sinus of Valsalva,^[1] is one of the anatomic dilations of the ascending aorta, which occurs just above the aortic valve. These widenings are between the wall of the aorta and each of the three cusps of the aortic valve.^[2]

Structure

There are generally three aortic sinuses, one anterior and two posterior sinuses. These give rise to coronary arteries:

The left posterior aortic sinus gives rise to the left coronary artery.
The anterior aortic sinus gives rise to the right coronary artery.
The right posterior aortic sinus usually gives rise to no vessels, and is often known as the non-coronary sinus.

The aortic sinuses are typically more prominent than the pulmonary sinuses.^[3]

Clinical significance

If the coronary arteries arise from the wrong aortic sinuses, this can put the heart's ventricles at risk of ischaemia.^[4] This is often only discovered when a heart attack has already occurred, usually before the age of 20 and during exercise.^[4]

Names

Each aortic sinus can also be referred to as the sinus of Valsalva,^[1] the sinus of Morgagni, the sinus of Mehta, the sinus of Otto, or Petit's sinus.

Related Research Articles

The aorta is the main and largest artery in the human body, originating from the left ventricle of the heart and extending down to the abdomen, where it splits into two smaller arteries. The aorta distributes oxygenated blood to all parts of the body through the systemic circulation.

Coronary circulation is the circulation of blood in the blood vessels that supply the heart muscle (myocardium). Coronary arteries supply oxygenated blood to the heart muscle, and cardiac veins drain away the blood once it has been deoxygenated. Because the rest of the body, and most especially the brain, needs a steady supply of oxygenated blood that is free of all but the slightest interruptions, the heart is required to function continuously. Therefore its circulation is of major importance not only to its own tissues but to the entire body and even the level of consciousness of the brain from moment to moment. Interruptions of coronary circulation quickly cause heart attacks, in which the heart muscle is damaged by oxygen starvation. Such interruptions are usually caused by coronary ischemia linked to coronary artery disease, and sometimes to embolism from other causes like obstruction in blood flow through vessels.

A heart valve is a one-way valve that normally allows blood to flow in only one direction through the heart. The four valves are commonly represented in a mammalian heart that determines the pathway of blood flow through the heart. A heart valve opens or closes incumbent on differential blood pressure on each side.

The aortic valve is a valve in the human heart between the left ventricle and the aorta. It is one of the two semilunar valves of the heart, the other being the pulmonary valve. The heart has four valves; the other two are the mitral and the tricuspid valves. The aortic valve normally has three cusps or leaflets, although in 1–2% of the population it is found to congenitally have two leaflets. The aortic valve is the last structure in the heart the blood travels through before stopping the flow through the systemic circulation.

Aortic dissection (AD) occurs when an injury to the innermost layer of the aorta allows blood to flow between the layers of the aortic wall, forcing the layers apart. In most cases, this is associated with a sudden onset of severe chest or back pain, often described as "tearing" in character. Also, vomiting, sweating, and lightheadedness may occur. Other symptoms may result from decreased blood supply to other organs, such as stroke or mesenteric ischemia. Aortic dissection can quickly lead to death from insufficient blood flow to the heart or complete rupture of the aorta.

The coronary arteries are the arterial blood vessels of coronary circulation, which transport oxygenated blood to the heart muscle. The heart requires a continuous supply of oxygen to function and survive, much like any other tissue or organ of the body.

dextro-Transposition of the great arteries Medical condition

dextro-Transposition of the great arteries, is a potentially life-threatening birth defect in the large arteries of the heart. The primary arteries are transposed.

Bicuspid aortic valve (BAV) is an inherited form of heart disease in which two of the leaflets of the aortic valve fuse during development in the womb resulting in a two-leaflet valve instead of the normal three-leaflet valve (tricuspid). BAV is the most common cause of heart disease present at birth and affects approximately 1.3% of adults. Normally, the mitral valve is the only bicuspid valve and this is situated between the heart's left atrium and left ventricle. Heart valves play a crucial role in ensuring the unidirectional flow of blood from the atrium to the ventricles, or from the ventricle to the aorta or pulmonary trunk.

Aneurysm of sinus of Valsalva Medical condition

Aneurysm of the aortic sinus, also known as the sinus of Valsalva, is a rare abnormality of the aorta, the largest artery in the body. The aorta normally has three small pouches that sit directly above the aortic valve, and an aneurysm of one of these sinuses is a thin-walled swelling. Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left coronary sinus. These aneurysms may not cause any symptoms but if large can cause shortness of breath, palpitations or blackouts. Aortic sinus aneurysms can burst or rupture into adjacent cardiac chambers, which can lead to heart failure if untreated.

Aortic valve replacement is a procedure whereby the failing aortic valve of a patient's heart is replaced with an artificial heart valve. The aortic valve may need to be replaced because:

In the blood supply of the heart, the right coronary artery (RCA) is an artery originating above the right cusp of the aortic valve, at the right aortic sinus in the heart. It travels down the right coronary sulcus, towards the crux of the heart. It supplies the right side of the heart, and the interventricular septum.

The coronary sinus is a collection of veins joined together to form a large vessel that collects blood from the heart muscle (myocardium). It delivers less-oxygenated blood to the right atrium, as do the superior and inferior venae cavae. It is present in all mammals, including humans.

The ascending aorta (AAo) is a portion of the aorta commencing at the upper part of the base of the left ventricle, on a level with the lower border of the third costal cartilage behind the left half of the sternum.

The small cardiac vein, also known as the right coronary vein, is a coronary vein that drains the right atrium and right ventricle of the heart. Despite its size, it is one of the major drainage vessels for the heart.

The middle cardiac vein commences at the apex of the heart; ascends in the posterior longitudinal sulcus, and ends in the coronary sinus near its right extremity.

The pericardial sinuses are impressions in the pericardial sac formed between the points where great vessels enter it.

The coronary sulcus is a groove on the surface of the heart that separates the atria from the ventricles. The structure contains the trunks of the nutrient vessels of the heart, and is deficient in front, where it is crossed by the root of the pulmonary trunk. On the posterior surface of the heart, the coronary sulcus contains the coronary sinus.

Coronary artery anomalies are variations of the coronary circulation, affecting <1% of the general population. Symptoms include chest pain, shortness of breath and syncope, although cardiac arrest may be the first clinical presentation. Several varieties are identified, with a different potential to cause sudden cardiac death.

Anomalous aortic origin of a coronary artery (AAOCA) is a rare congenital heart defect in which a coronary artery inappropriately arises from the aorta, usually from the incorrect sinus of Valsalva. This anomalous coronary artery often takes an interarterial, intraconal, or intramural course, and is associated with an increased risk of sudden death in children.

Heart is a muscular organ sited in the mediastinum. It consist of four chambers, four valves, arteries, and the conduction system. Heart functionally can be separated in left and right side. Right heart receives blood coming from the body through superior and inferior vena cava. It pumps blood to the lungs through the pulmonary artery and left heart receives saturated blood from the lungs.

References

1 2 Weinreich, Michael; Yu, Pey-Jen; Trost, Biana (2015). "Sinus of Valsalva Aneurysms: Review of the Literature and an Update on Management". Clinical Cardiology. 38 (3): 185–189. doi:10.1002/clc.22359. ISSN 1932-8737. PMC 6711005 . PMID 25757442.
↑ Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier. p. 1719. ISBN 978-1-4160-6257-8.
↑ Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (2012-01-01), Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (eds.), "Chapter 23 - Adenosine-Sensitive (Outflow Tract) Ventricular Tachycardia", Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease (Second Edition), Philadelphia: W.B. Saunders, pp. 562–586, doi:10.1016/b978-1-4557-1274-8.00023-3, ISBN 978-1-4557-1274-8 , retrieved 2020-11-11
1 2 Thiene, G.; Rizzo, S.; Basso, C. (2016-01-01), Buja, L. Maximilian; Butany, Jagdish (eds.), "Chapter 10 - Pathology of Sudden Death, Cardiac Arrhythmias and Conduction System", Cardiovascular Pathology (Fourth Edition), San Diego: Academic Press, pp. 361–433, doi:10.1016/b978-0-12-420219-1.00010-0, ISBN 978-0-12-420219-1 , retrieved 2020-11-11

External links

Anatomy photo:20:29-0108 at the SUNY Downstate Medical Center - "Heart: The Aortic Valve and Aortic Sinuses"

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[:1-1] 1 2 Weinreich, Michael; Yu, Pey-Jen; Trost, Biana (2015). "Sinus of Valsalva Aneurysms: Review of the Literature and an Update on Management". Clinical Cardiology. 38 (3): 185–189. doi:10.1002/clc.22359. ISSN 1932-8737. PMC 6711005 . PMID 25757442.

[2] Dorland's (2012). Dorland's Illustrated Medical Dictionary (32nd ed.). Elsevier. p. 1719. ISBN 978-1-4160-6257-8.

[3] Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (2012-01-01), Issa, Ziad F.; Miller, John M.; Zipes, Douglas P. (eds.), "Chapter 23 - Adenosine-Sensitive (Outflow Tract) Ventricular Tachycardia", Clinical Arrhythmology and Electrophysiology: A Companion to Braunwald's Heart Disease (Second Edition), Philadelphia: W.B. Saunders, pp. 562–586, doi:10.1016/b978-1-4557-1274-8.00023-3, ISBN 978-1-4557-1274-8 , retrieved 2020-11-11

[:0-4] 1 2 Thiene, G.; Rizzo, S.; Basso, C. (2016-01-01), Buja, L. Maximilian; Butany, Jagdish (eds.), "Chapter 10 - Pathology of Sudden Death, Cardiac Arrhythmias and Conduction System", Cardiovascular Pathology (Fourth Edition), San Diego: Academic Press, pp. 361–433, doi:10.1016/b978-0-12-420219-1.00010-0, ISBN 978-0-12-420219-1 , retrieved 2020-11-11

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