The Right Coronary Anatomy and Operative Topography of the Tricuspid Valve Annulus

TL;DR

This study maps the anatomy of the tricuspid valve and right coronary artery to identify high-risk areas for surgical damage.

Contribution

The study provides new insights into the spatial relationships between the tricuspid valve annulus and right coronary artery.

Findings

Danger zones with less than 2 mm distance between artery and annulus were found in 20.56% of cases.

The highest risk of iatrogenic damage occurs at the posterior part of the tricuspid valve annulus.

No sex-specific differences were observed in the distribution of danger zones.

Abstract

Background: The region of the tricuspid valve is an important area for various cardiac interventions. In particular, the spatial relationships between the right coronary artery and the annulus of the tricuspid valve should be considered during surgical interventions. The aim of this study was to provide an accurate description of the clinical anatomy and topography of this region. Methods: We analyzed 107 computed tomography scans (44% female, age 62.1 ± 9.4 years) of the tricuspid valve region. The circumference of the free wall of the tricuspid valve annulus was divided into 13 annular points and measurements were taken at each point. The prevalence of danger zones (distance between artery and annulus less than 2 mm) was also investigated. Results: Danger zones were found in 20.56% of the cases studied. The highest prevalence of danger zones and the smallest distances were found at the annular points of the tricuspid valve located at the posterior insertion of the leaflets, without observed sex-specific differences. Conclusion: The highest risk of iatrogenic damage to the right coronary artery is in the posterior part of the tricuspid valve annulus.

Figures